MODERNISING SCIENTIFIC CAREERS
Scientist Training Programme
Work Based Training
Learning Guide
CELLULAR SCIENCES
2012/13
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STP WORK BASED PROGRAMME IN
CELLULAR SCIENCES
Contents
SECTION 1: GENERAL INTRODUCTION ................................................................. 4
READERSHIP ..................................................................................................................... 5
1.1 Scientist Training Programme (STP) Overview ......................................................... 6
1.2 Outcomes of the work based STP .............................................................................. 9
1.3 Key Components of Work Based Training in STP................................................... 11
1.4 Host Training Departments ........................................................................................ 12
1.5 National School of Healthcare Science (NSHCS) and the STP ............................. 16
1.6 The Structure of the Learning Frameworks .............................................................. 17
1.7 Assessment during Work Based Training ................................................................ 18
1.8 Quality Assurance and Quality Management ........................................................... 21
SECTION 2: PROGRAMME OVERVIEW ................................................................ 23
SECTION 3: ROTATIONAL LEARNING FRAMEWORKS ...................................... 30
Principles and Practice of Cervical Cytology and Diagnostic Cytopathology (CP-1) . 32
Introduction to Principles and Practice of Histopathology (HP-1)................................. 38
Principles and Practice of Reproductive Science and Diagnostic Semen Analysis (RS-1) ... 45
Genetics and Molecular Science (CG-1) ........................................................................ 51
SECTION 4: PROFESSIONAL PRACTICE LEARNING FRAMEWORK................. 57
Professional Practice (PP1) ............................................................................................. 60
SECTION 5: ELECTIVE LEARNING FRAMEWORK............................................... 71
Elective (EL)....................................................................................................................... 73
SECTION 6: SPECIALIST LEARNING FRAMEWORK CYTOPATHOLOGY ......... 75
Pathological Basis of Disease (CP-2) ............................................................................. 78
Systematic Investigation of Pathological Specimens (CP-3) ........................................ 83
Major Organ Histopathology including Cancer (CP-4) .................................................. 87
Gynaecological Cytopathology (CP-5) ............................................................................ 93
Non-Gynaecological Cytopathology (CP-6) .................................................................... 98
SECTION 7: SPECIALIST LEARNING FRAMEWORK HISTOPATHOLOGY ...... 103
Pathological Basis of Disease (HP-2) ........................................................................... 106
Systematic Investigation of Pathological Specimens (HP-3) ...................................... 111
Major Organ Histopathology excluding Cancer (HP-4) ............................................... 115
Cancer (HP-5).................................................................................................................. 121
Specialised Histopathology (HP-6) ................................................................................ 127
SECTION 8: SPECIALIST LEARNING FRAMEWORK REPRODUCTIVE SCIENCE . 132
Infertility, Treatment and Role of Regulation (RS-2) .................................................... 135
Gametes and Fertilisation (RS-3) .................................................................................. 139
Culture of Gametes and Embryos (RS-4) ..................................................................... 144
Micromanipulation and Cryopreservation (RS-5) ......................................................... 148
Embryology (RS-6) .......................................................................................................... 152
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SECTION 9: CONTRIBUTORS .............................................................................. 155
SECTION 10: APPENDICES ................................................................................. 157
APPENDIX 1: GLOSSARY ............................................................................................ 158
APPENDIX 2: GOOD SCIENTIFIC PRACTICE ........................................................... 160
APPENDIX 3: FURTHER INFORMATION ................................................................... 167
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SECTION 1: GENERAL INTRODUCTION
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READERSHIP
This Scientist Training Programme (STP) Learning Guide describes the STP work based
training programmes in the UK:
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Trainees, host departments and managers of services that employ healthcare
science staff;
Work based trainers, which includes all those involved in supervising, coordinating,
assessing and delivering education and training;
Academic and administrative staff within Higher Education Institutions (HEIs);
Strategic Health Authorities (SHAs), and their successor health and education
commissioning bodies;
Those involved in Modernising Scientific Careers (MSC) accreditation events and
reviews.
A glossary of terms used is provided in Appendix 1.
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Introduction
1.1 Scientist Training Programme (STP) Overview
1. Healthcare science (HCS) involves the application of science, technology, engineering
and mathematics to health. Good Scientific Practice (GSP) [Appendix 2] sets out the
principles and values on which education and training for healthcare science are
founded. It makes explicit the professional standards of behaviour and practice that
must be achieved and maintained in the delivery of work activities and clinical care for
all those who work in healthcare science, the public and healthcare providers.
2. GSP and the Education and Training Standards of the Health and Care Professions
Council (HCPC) are the basis for all MSC training curricula which contextualise the
Standards of Proficiency set down by the HCPC in a way that is accessible to the
profession and the public.
3. The healthcare science workforce and services have traditionally been grouped into
three broad areas called Divisions, namely: Life Sciences/Clinical Laboratory Sciences,
Physical Sciences/Medical Physics and Biomedical Engineering and Physiological
Sciences/Clinical Physiology Sciences. Within each Division there are a number of
healthcare science specialisms. With advances in scientific technology, changes to the
delivery of healthcare scientific services and the development of MSC, the boundaries
between these Divisions have been shifting. MSC recognises this important change
and to date has identified nine themes within healthcare science for the STP, which
enables training across a total of 24 healthcare science specialisms, with curricula for
additional specialisms still under development.
4. The STP is designed to provide healthcare scientist trainees with strong sciencebased, patient-centred clinical training in a specialist area of healthcare science. Initial
rotational training provides a broad base of knowledge, skills and experience across a
group of related cognate specialisms reflective of the evolving clinical and scientific
changes and requirements followed by specialisation in a single HCS specialism.
5. During the STP programme the scientist trainee is supernumerary but may contribute to
the clinical work of the department in which they are training to gain the required clinical
experience and competence.
6. The STP is an integrated training programme combining academic study leading to the
award of a specifically commissioned MSc in Clinical Science and a work based
training programme. Completion of both will lead to the award of a Certificate of
Completion of the Scientist Training Programme (CCSTP) by the National School of
Healthcare Science (NSHCS). Graduates are then eligible to apply to the Academy for
Healthcare Science for a Certificate of Attainment and will then be eligible to apply to
HCPC for registration as a Clinical Scientist.
7. The MSc Clinical Science Learning Outcomes and Indicative Content, and the
associated work based learning outcomes, can be found by following the link
www.networks.nhs.uk/nhs-networks/msc-framework-curricula. Further details of the
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MSc in Clinical Science can be found in the student handbook from the university with
which each trainee is registered.
8. This Introduction to Work Based Learning provides an overview of the work-based
training programme and the guidance provided by the NSHCS for users of the Online
Assessment Tool (OLAT) and e-learning Portfolio. All trainees and trainers will have
access to the OLAT throughout their training. In addition, The Reference Guide for
Healthcare Science Training and Education in England will be published in autumn
2012. This will contextualise the STP within the wider MSC programme.
9. All STP trainees will be registered with the NSHCS for the duration of their training and
will be allocated a National Science Training Number (NSTN). The NSHCS working
through its Themed Boards provides oversight and coordination of the STP,
communicates with trainees and trainers with respect to national policy and events,
liaises with the work based trainers, host employers and the academic providers,
reviews progress on assessments and trainee performance including OLAT/ Structured
Final Assessment (SFA) and quality assurance of the work place training environment.
The School overall has a responsibility to provide confidential reports in accordance
with agreed governance and oversight arrangements.
10. The work based training programme has four components each underpinned by the
professional practice curriculum:
• Induction;
• Rotational Training;
• Elective Training;
• Specialist Training.
11. It is anticipated that trainees will have a brief induction period in their host employing
organisation prior to commencing the introduction to their MSc in Clinical Science. As
the induction period may be up to 6 weeks in some departments the time should be
used to begin rotational training as well as the induction period. The subsequent
initial academic period is specifically designed to give an overview of the basic
science and an introduction to aspects of professional practice relevant to HCS and
the STP rotational training. The duration of this first university session will vary,
depending on the MSc degree which is undertaken.
12. Details of the work based assessment programme can be found in Section III of this
guide and also by logging onto the online assessment tool. Details of the assessment
programme for the MSc in Clinical Science will usually be published in the student
handbook provided by each university.
A broad overview of the STP is shown in the diagram overleaf:
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Modernising Scientific Careers: Scientist Training Programme (STP):
Diagrammatic representation of employment-based, pre-registration 3 year
NHS commissioned education and training programme
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1.2 Outcomes of the work based STP
13. On successful completion of the work based STP trainees will have clinical and
specialist expertise in a specific healthcare science specialism, underpinned by
broader knowledge and experience within a healthcare science division or theme.
They will undertake complex scientific and clinical roles, defining and choosing
investigative and clinical options, and making key judgements about complex facts and
clinical situations. Many will work directly with patients and all will have an impact on
patient care and outcomes. They will be involved, often in lead roles, in innovation and
improvement, research and development and education and training. Some will
pursue explicit academic career pathways, which combine clinical practice and
academic activity in research, innovation and education.
On successful completion of the work-based training programme which forms part of
the MSC STP, trainees will possess the essential knowledge, skills, experience and
attributes required for their role and should demonstrate:
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A systematic understanding of clinical and scientific knowledge, and a critical
awareness of current problems, future developments, research and innovation in
health and healthcare science practice, much of which is at, or informed by, the
forefront of their professional practice in a healthcare environment;
Clinical and scientific practice that applies knowledge, skills and experience in a
healthcare setting, places the patient and the public at the centre of care prioritising
patient safety and dignity and reflecting NHS/health service values and the NHS
Constitution;
Clinical, scientific and professional practice that meets the professional standards
defined by GSP and the regulator (HCPC);
Personal qualities that encompass self-management, self-awareness, acting with
integrity and the ability to take responsibility for self-directed learning, reflection and
action planning;
The ability to analyse and solve problems, define and choose investigative and
scientific and/or clinical options, and make key judgements about complex facts in a
range of situations;
The ability to deal with complex issues both systematically and creatively, make
sound judgements in the absence of complete data, and to communicate their
conclusions clearly to specialist and non-specialist audiences including patients and
the public;
The ability to be independent self-directed learners demonstrating originality in
tackling and solving problems and acting autonomously in planning and
implementing tasks at a professional level;
A comprehensive understanding of the strengths, weaknesses and opportunities for
further development of healthcare and healthcare science as applicable to their own
clinical practice, research, innovation and service development which either directly
or indirectly leads to improvements in clinical outcomes and scientific practice;
alternative;
Conceptual understanding and advanced scholarship in their specialism that
enables the graduate to critically evaluate current research and innovation
methodologies and develop critiques of them and, where appropriate, propose new
research questions and hypotheses;
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Scientific and clinical leadership based on the continual advancement of their
knowledge, skills and understanding through the independent learning required for
continuing professional development.
14. Once registered as a Clinical Scientist, a range of career development options will
be available including competitive entry into Higher Specialist Scientist Training
(HSST). Alternatively, others may choose to undertake further career development
in post through a structured programme of Continuing Professional Development
(CPD), provided by Accredited Expert Scientific Practice or pursue a clinical
academic career. Clinical Scientists who successfully complete HSST, or who can
demonstrate equivalence to its outcomes, will be eligible to compete for available
Consultant Clinical Scientist posts.
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1.3 Key Components of Work Based Training in STP
The Trainee
15. The trainee is at the centre of the STP, supported on the one hand by the national
oversight role taken by the NSHCS, working closely with local quality monitoring and
performance processes currently undertaken by SHAs and on the other by the day-today delivery of training in the workplace, facilitated by the underpinning and integrated
MSC in Clinical Science programme. This Guide contains important information which
will help the trainee understand how the work based programme operates and its key
elements.
16. At the core of successful work based training is appropriate educational supervision,
facilitation and feedback. Each trainee will be allocated to a clinical training supervisor
or training officer1 from within the employing host department. Trainees should ensure
that a planned schedule of meetings with their training officer is agreed early in training,
commencing with a meeting during the first week. Conversations between trainees and
trainers are confidential, unless patient safety is at risk. When the trainee is following a
rotational module a trainer from the host department will act as their main contact whilst
they are away from their host department.
17. The local training departments, supported by the NSHCS working with others, are
responsible for ensuring that trainees have access to training opportunities to enable
the achievement of the learning outcomes of the STP. In return trainees are expected
to take responsibility for:
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ensuring that they fulfill their obligations to their employer and to patients
(especially with regard to patient safety and confidentiality) as healthcare
professionals;
engaging as active adult learners by initiating work based assessments;
contributing to learning activities; taking into account feedback received from their
trainers and assessors and; giving considered and constructive feedback on their
experience of their training;
meeting the requirements of the academic MSc Clinical Science programme.
18. Critical reflection on progress and performance is an integral part of both the STP and
of being a professional. Trainees should therefore regularly critically reflect on their
progress and performance, enabling them to develop skills in self-evaluation and action
planning.
1
For the purposes of this document Training Officer has be used however the title may vary between departments and may be
subject to a title change in England as part of developments for the whole of the professional healthcare workforce. In essence this
is the person in the host department who is responsible for the training of each trainee for the duration of the 3 years.
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1.4 Host Training Departments
19. The third key component for successful training in the STP is the employing host
department and other service units facilitating work based training. The success of the
training and the trainee experience requires the commitment and enthusiasm of those
in the work base who provide the training.
20. Host departments should therefore ensure that they are fully familiar with the four
components of the work based training programme, namely: induction, rotational,
elective and specialist; the underpinning professional practice curriculum and be aware
of how the academic MSc in Clinical Science degree integrates with work based
training.
21. All trainees must have a designated training officer who will have responsibility for:
• provision of support, guidance and mentoring for the duration of the programme, in
the host department and related training environments;
• provision of a timetable which enables an appropriate balance of work and learning
for the trainee;
• ensuring adequate support during periods of training outside the host department;
• ensuring that the programme of work based assessment is understood and that its
outcomes for individual trainees is documented through the use of OLAT;
• ensuring that the e-learning Portfolio is discussed with the trainee and that there is
clarity and agreement about its use;
• ensuring that clinical practice is well supervised for the safety of patients and the
trainee, so that the acquisition of clinical competence is facilitated;
• ensuring that other contributors to the assessment process are fully aware of the
requirements and the use of the OLAT.
Organisation of the Training Programme
22. The host department is responsible for organising the training programme for each
of its trainees. This may involve liaising with other departments to facilitate
necessary work based learning and other contributors to the associated assessment
requirements. Whilst the NSHCS will provide support, host departments need to be
satisfied that they are providing a training environment of appropriate quality
including appropriately trained staff and facilities. Furthermore, host departments
are required to engage in the quality assessment management process established
by the NSHCS and provide information as necessary to enable the NSHCS to fulfil
this critical function. Details of the NSHCS quality assessment management policy
for work based training provider departments can be found at:www.nshcs.org.uk.
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23. Induction
At the start of the STP training programme and of each new placement, trainees
should be provided with an induction programme explaining trust and departmental
arrangements. Initial work based induction in the host department should include an
overview of the:
• hospital/healthcare setting and local policies including health and safety,
confidentiality, data protection etc relevant to the placement;
• range of services provided by the department;
• range of people who use the services provided by the department;
• function, operation and routine and corrective maintenance requirements of
equipment appropriate to the section(s) of the department in which the trainee
will be working.
Moreover, the host department should ensure that the trainee has access to:
• Host Trust IT systems including the library and knowledge service as
necessary;
• On-line Assessment and Personal Management System.
Induction should include an early discussion (within the first week) between the
trainee and his/her training officer so that the curriculum, assessment and placement
arrangements can be discussed. In addition, trainers should provide trainees with
copies of:
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Good Scientific Practice;
The STP work based Learning Guide;
The OLAT learning guide;
Links to the NSHCS (see section III for details of the role of the NSHCS in
relation to STP training).
24. Rotational Training
During rotational training each trainee will undertake four rotations which will include
a rotation in the area in which they will subsequently specialise. Trainees must
successfully achieve all of the learning outcomes. Each rotational placement should
be of approximately 12 weeks duration. It is the responsibility of the host department
to organise this rotational programme and to liaise with the trainers in the rotational
placement departments on the requirements of work based training and supervision
and the use of the online assessment tool. The NSHCS and the SHA MSC leads
(and successors) will help to facilitate rotational placements for small specialisms or
where there are local issues in respect of access to particular training elements.
The host department is responsible for setting the timetable for each of the 4
rotations, which will depend on local availability and may require some time to be
spent out with your locality to ensure that the learning outcomes in totality can be
achieved. In agreeing the rotational training the host department will need to
consider the periods of time the trainee will be required to attend the University or
undertake academic activities for the MSc within the work place.
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The host department must be familiar with the content, delivery and assessment
programme of the MSc in Clinical Science which the trainee is undertaking at
university and ensure that the departments where the trainee is placed for rotational
placements are also familiar with the expected outcomes of each period of training
and are trained in the assessment methods. The training officer in the host
department should maintain contact with the trainee and should liaise with the
person taking overall responsibility for the trainee whilst they are undertaking the
rotation. Supervision meetings between the training officer and the trainee should
continue whilst they are on their rotational placements.
25. Elective Training
Each trainee must undertake elective training and successfully achieve all of the
learning outcomes. The host department should agree the timing and content of the
elective training period with the trainee and should then inform the NSHCS of the
plans for the elective by completing the appropriate form and submitting it to the
School. The aim of the elective is to facilitate a wider experience of health care
and/or the practice of healthcare science in a cultural and/or clinical setting that is
different from the usual training environment. This may involve health care or
healthcare science in a different area of the health service and may involve study
abroad or pursuit of a particular clinical or research interest. The elective period can
be taken any time during the specialist training, and may comprise a single period of
4–6 weeks or a series of shorter periods of elective training. It is important that the
trainee is able to express their preferences for the elective period which is designed
to provide a broader experience and for these to be fully taken into consideration.
26. Specialist Training
The host department will plan the timetable for specialist training. This will usually be
in a single health care science specialism (except for Gastrointestinal Physiological
and Urodynamic Science who share modules in the specialist training period, and
Immunogenetics and Histocompatibility who share some specialist modules with
Clinical Immunology). Each trainee must successfully achieve all of the learning
outcomes in the specialist training modules including, by the end of the training
programme, all of the professional practice learning outcomes. If the host department
itself is unable to provide the necessary work based training to enable the trainee to
complete all of the required learning outcomes, it will need to arrange training in other
training departments and environments.
27. Supervision
STP clinical and educational supervision should promote learning, reflective practice
and support the trainee to produce action plans to address identified learning needs.
It will need to ensure that the trainee learns specific skills and competencies, helping
them to develop self-sufficiency and self-awareness in the ongoing acquisition of
skills and knowledge. At every stage, patient safety must be paramount. Supervision
will require the provision of pastoral care for some trainees. Supervision may, at
times during the programme, be provided by other healthcare professionals outside
of healthcare science who will be appropriately trained e.g. medical colleagues.
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The first supervision meeting should be set up during the first week of the training
programme. At this meeting the training officer should ensure that the trainee is
undertaking an induction programme that includes the hospital and department. It is
recommended that following areas should be explored and agreement reached at the
first meeting with respect to the:
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expectations of the training officer and trainee;
responsibilities of the training officer and trainee;
boundaries between the training officer and trainee;
confidentiality;
frequency and duration of planned supervision meetings;
methods of communication and responsibility for arranging meetings;
level of support and arrangements for communications between meetings;
models of reflection and action planning;
record keeping;
content of the work based training programme;
the approach to assessment and the use of the assessment tools and the
online system;
sources of help and support.
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1.5 National School of Healthcare Science (NSHCS) and the STP
28. The NSHCS provides a national coordinating and oversight function to support trainees
and host departments in the delivery of training. It is responsible for:
• national recruitment into STP, enabling a transparent and robust selection of the
very best science graduates;
• providing national oversight of STP trainees throughout their training by managing
and monitoring their progress through the OLAT, supporting trainees in difficulty as
well as co-ordinating national structured assessments both during and at the end of
STP training;
• evaluation of ongoing work based assessment outcomes through the OLAT,
enabling
the School to benchmark training programme delivery for early
identification of programme issues which may need to be addressed and resolved
and reporting these as part of agreed MSC governance arrangements;
• liaising with each HEI’s MSc Clinical Science programme director to ensure the
integration and coordination needed to deliver the academic and work based
programmes that form the STP;liaising with MSC SHA leads (and education and
quality leads in the future arrangements) on local issues and problems and their
resolution;
• working closely with work place training departments and providing support as
appropriate;
• organising national ‘Train the Trainer’ programmes to ensure common standards of
delivery and content and recommending on-going training activities to support the
continuing professional development of work based trainers.
Professional Leads in each of the scientific divisions within the NSHCS will provide help
and support with respect to organising rotations and/or specialist training that might
require national coordination. In order to optimise the educational benefit and value of
OLAT and the e-learning Portfolio, Professional Leads will also work with and support
training departments in its use.
The School can be contacted on the following email [email protected] and at
www.nshcs.org.uk .
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1.6 The Structure of the Learning Frameworks
29. The work-based programme is divided into modules, with each module following a
standard format. The aim and scope of the module are described followed by:
• Learning outcomes – high level descriptors of required achievements for module;
• Clinical Experiential Learning – the learning activities that will facilitate learning and
achievement of stated outcomes;
• Competences – further, outcome based statements for each Learning Outcome;
• Knowledge and Understanding as APPLIED to appropriate competences.
All of the above are focused on service need, patient care/pathway and continuous
service improvement
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1.7 Assessment during Work Based Training
Trainee Assessment
30. The work-based assessment is designed to promote learning, skill development and
competence within the specialist healthcare context. Trainees will be able to identify
areas for development and improvement.
The assessment programme is designed to enable both trainee and trainer to obtain
regular feedback on progress and achievement. It aims to nurture the trainee by
providing professional educational support and encouraging critical reflection and
generating regular feedback about progression. The programme embeds assessment
tools to enable trainees to learn and develop but also to generate evidence so that
judgments about progression can be made and areas identified for trainee
improvement based on supportable evidence.
The work-based education and training programme should offer a constructive
environment where a trainee understands that he/she is still developing and the
assessment tools are intended for use in this context. As part of each assessment, the
work-base assessor will facilitate a discussion in which the trainee is encouraged to
reflect on his/her performance and identify his/her strengths and areas that could be
improved, setting an action plan to achieve that improvement.
31. The structure of the work based assessment programme.
There are distinct elements of the work-based assessment programme for all trainees:
• Assessment Tools, see Table 1 overleaf;
• Competency Log;
• Online Assessment and Personal Learning Management System (OLAT);
• Exit assessment – Objective Structured Final Assessment (OSFA).
Assessment Tools
32.
The assessment programme utilises a range of work-based assessment tools,
designed to promote continuous assessment and generate feedback throughout
training. The assessment promotes student centred feedback to enable the trainee
to gain skills in self-assessment. There is a requirement for each trainee to engage
with the assessment process and to complete a defined number and range of
assessments to successfully complete each module. These are set out in OLAT.
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Table 1 Summary of the STP Work Based Assessment Tools
Assessment
Tool
Direct observation of
practical skills (DOPS)
Purpose
To assess a practical
skill or procedure which
may include interaction
with a patient. Feedback
is generated, learning
needs identified and an
action plan generated.
To assess a clinical
encounter.
The assessor observes
a practical activity and
facilitates student
centred feedback either
during or immediately
following the
observation. The
trainee then generates
an action plan.
The assessor observes a
clinical activity and
facilitates student centred
feedback either during or
immediately following the
observation. The trainee
then generates an action
plan.
Method
Observed clinical
event (OCE)
Case based discussion
(CbD)
Multi source feedback
(MSF)
To assess the trainee’s
To provide a sample of
attitudes and opinions of
colleagues on the
performance and
professional behaviour of
the trainee. It helps to
provide data for reflection on
performance and gives
useful feedback for selfevaluation.
Using an on-line system the
trainee gains feedback from
a range of people (8–10)
who work with them and the
trainee also rates
themselves. On completion
the report generated is
reviewed in a discussion
between the trainee and
trainer and using critical
reflection an action plan
generated by the trainee.
ability to apply their
knowledge and
understanding of an
aspect of an activity for
example the underpinning
science, aspects of
professional practice .
The assessor facilitates a
discussion with the
trainee about a clinical
case with which the
trainee has been
involved. This may
include a report, record,
result or an aspect of
professional practice
arising from the case.
Following the discussion
the trainee generates an
action plan.
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33. Competences
All trainees are required to provide evidence to demonstrate that they have
completed each competence which should then, at the request of the trainee, be
signed off by a trainer. Trainees will gain competence at their own pace, but in
line with the overall delivery of the relevant modules. Each competence may link
directly to a specific learning outcome and some competences may be linked to
more than one learning outcome, therefore successful completion cannot be
achieved until demonstrated for all learning outcomes. All of the competences
are contained within a competency log within the OLAT.
Completion of the competency log is essential for progression within the
programme and in order to exit from the programme. The expectation is that as
the trainee progresses the competency log will demonstrate an evidence base of
achievement.
34. Online Assessment and Personal Management Tool (OLAT)
The achievement of competences and all work based assessments are recorded
on OLAT. OLAT is customised for each specialism and contains all the above
assessment tools as well as the full list of competences for each programme and
a reflective log.
NSHCS will provide trainees with the information to allow them to register on
OLAT at the start of their programme. As part of their registration they must
nominate their training officer, even though others may contribute during the total
period of work base training to the assessment process.
Short film clips which explain the principles of the assessment process and how
to use each of the assessment tools are available on OLAT.
35. Objective Structured Final Assessment
At the end of training trainees will be assessed using an Objective Structured
Final Assessment (OSFAs). This is a performance based assessment used to
measure trainees across a number of different stations encompassing scientific,
clinical and professional practice. The NSHCS, in partnership with the
professional bodies and supported by the NSHCS Themed Boards, will design
and deliver the OSFA and the Academy for Healthcare Science will provide
external Quality Assurance
All trainees will have the opportunity to undertake an OSFA mid-programme to
provide formative experience of this assessment.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
1.8 Quality Assurance and Quality Management
Quality Assurance of work based training
36. All host and training departments are responsible for the delivery of the work
based training quality standards detailed in the Learning and Development
Agreement (LDA) agreed with and issued by with the local Strategic Health
Authority (SHA) and their successor bodies. All host and training departments
providing training for trainees on the STP must also be MSC approved and
accredited.
37. MSC work-based accreditation is carried out by the NSHCS on behalf of MSC.
38. The NSHCS provides oversight of the quality management and quality control of
the STP work based training environments as agreed by the appropriate MSC
governance arrangements and to be maintained into the future.
39. The NSHCS works in partnership with the professional bodies through its
Themed Boards and the SHAs/LETBs to deliver a robust Quality Assessment
Management (QAM) programme for the work based education and training
programme. This QAM programme is UK wide and independent from the direct
delivery of education and training. The purposes of the QAM programme are to:
•
•
•
•
•
•
•
all STP training environments are accredited to deliver work based training;
ensure that all training settings are working to the agreed standards;
create an open and transparent culture where issues and concerns can be
raised, investigated and resolved;
ensure that trainees receive a high quality educational experience wherever
their training takes place;
Identify and share examples of good practice;
provide evidence of the quality of work based education and training
environments to those who regulate and register the profession;
provide evidence of the high standard of work based education and training
and assurance that these standards are robustly managed.
40. Details of the quality management approach is available from the NSHCS (Ref
NSHCS Policy 03), in summary, the quality framework includes:
•
Receipt, analysis, review and response with respect to:
o annual self assessment progress reports from each work base;
o trainee feedback questionnaires;
o assessment progress reports;
o ad hoc reporting of exceptions or changes to programmes;
o individual work based education and training timetables for each
trainee;
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
•
•
A mechanism for receiving and reviewing reports with respect to the STP
programme from trainees, trainers, patients or other stakeholders;
Visit Programme including:
o a five year rolling visit programme to each work base;
o adhoc visits to departments as required.
41. The NSHCS monitors the progress of each trainee and provides support for
trainees in difficulty (Trainees in Difficulty Ref NSHCS Policy 04). Staff in the
NSHCS also regularly review the STP programmes using information from the
OLAT and other sources through the Themed Boards (See NSHCS Policy 01)
42. The QAM processes, established jointly by the MSC governance arrangements
involving all current SHAs and the NSHCS, do not absolve the training
provider from responsibility for continuously managing and maintaining the
quality of its own provision. Local training departments are responsible for
ongoing quality control and local education providers should therefore ensure that
a high quality education and training environment is maintained.
The following sections of this Learning Guide include an overview of the STP work
based programme for the specialisms within this theme. This is followed by the
Learning Frameworks for the Rotational, Elective, Specialist and Professional
Practice components of the programme.
Further information can be found in Appendix 3.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
SECTION 2: PROGRAMME OVERVIEW
CELLULAR SCIENCES
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
STP WORK BASED TRAINING PROGRAMME IN
CYTOPATHOLOGY
The diagram below provides an overview of the programme each trainee in
Cytopathology will follow:
Modernising Scientific Careers: Scientist Training Programme (STP):
Diagrammatic representation of employment based, 3-year NHS
commissioned, pre-registration Education and Training programme
PROFESSIONAL PRACTICE
This module spans the whole of the 3-year training programme, underpinning both
work based training and the MSc in Clinical Science.
INDUCTION COMPONENT
At the start of the training programme and of each new placement all trainees will
complete an induction programme.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
ROTATIONAL COMPONENT
Trainees must then successfully complete the Cytopathology rotation followed
by the other THREE rotations listed below:
Rotation 1 (CP-1)
Rotation 2 (HP-1)
Rotation 3 (RS-1)
Rotation 4 (CG-1)
Principles and Practice of Cervical Cytology and
Diagnostic Cytopathology
Introduction to Principles and Practice of Histopathology
Principles and Practice of Reproductive Science and
Diagnostic Semen Analysis
Genetics and Molecular Science
Duration: Each rotation should be of approximately 12 weeks duration.
Order: It is expected that the first rotation completed will be Cytopathology.
ELECTIVE COMPONENT
The elective period can be taken any time during the specialist training. It may
comprise a single 4- to 6-week elective or a series of shorter periods of elective
training.
SPECIALIST COMPONENT
Module 1 (CP-2)
Pathological Basis of Disease
Module 2 (CP-3)
Systematic Investigation of Pathological Specimens
Module 3 (CP-4)
Major Organ Histopathology including Cancer
Module 4 (CP-5)
Gynaecological Cytopathology
Module 5 (CP-6)
Non-Gynaecological Cytopathology
The following sections of the learning guide contain the learning frameworks
for the rotational, elective, specialist and professional practice modules.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
STP WORK BASED TRAINING PROGRAMME IN
HISTOPATHOLOGY
The diagram below provides an overview of the programme each trainee in
Histopathology will follow:
Modernising Scientific Careers: Scientist Training Programme (STP):
Diagrammatic representation of employment based, 3-year NHS
commissioned, pre-registration Education and Training programme
PROFESSIONAL PRACTICE
This module spans the whole of the 3-year training programme, underpinning both
work based training and the MSc in Clinical Science.
INDUCTION COMPONENT
At the start of the training programme and of each new placement all trainees will
complete an induction programme.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
ROTATIONAL COMPONENT
Trainees must then successfully complete the Histopathology rotation followed
by the other THREE rotations listed below:
Rotation 1 (HP-1)
Introduction to Principles and Practice of Histopathology
Rotation 2 (CP-1)
Principles and Practice of Cervical Cytology and
Diagnostic Cytopathology
Principles and Practice of Reproductive Science and
Diagnostic Semen Analysis
Genetics and Molecular Science
Rotation 3 (RS-1)
Rotation 4 (CG-1)
Duration: Each rotation should be of approximately 12 weeks duration.
Order: It is expected that the first rotation completed will be Histopathology.
ELECTIVE COMPONENT
The elective period can be taken any time during the specialist training. It may
comprise a single 4- to 6-week elective or a series of shorter periods of elective
training.
SPECIALIST COMPONENT
Module 1 (HP-2)
Pathological Basis of Disease
Module 2 (HP-3)
Systematic Investigation of Pathological Specimens
Module 3 (HP-4)
Major Organ Histopathology excluding Cancer
Module 4 (HP-5)
Cancer
Module 5 (HP-6)
Specialised Histopathology
Duration: The work based component of the five specialist modules should be
completed during the specialist training period. The work based component of the
modules can run in parallel in order to use the time and clinical contacts to best
advantage.
The following sections of the learning guide contain the learning frameworks
for the rotational, elective, specialist and professional practice modules.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
STP WORK BASED TRAINING PROGRAMME IN
REPRODUCTIVE SCIENCE
The diagram below provides an overview of the programme each trainee in
Reproductive Science will follow:
Modernising Scientific Careers: Scientist Training Programme (STP):
Diagrammatic representation of employment based, 3-year NHS
commissioned, pre-registration Education and Training programme
PROFESSIONAL PRACTICE
This module spans the whole of the 3-year training programme, underpinning both
work based training and the MSc in Clinical Science.
INDUCTION COMPONENT
At the start of the training programme and of each new placement all trainees will
complete an induction programme.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
ROTATIONAL COMPONENT
Trainees must then successfully complete the Reproductive Science rotation
followed by the other THREE rotations listed below:
Rotation 1 (RS-1)
Rotation 2 (HP-1)
Rotation 3 (CP-1)
Rotation 4 (CG-1)
Principles and Practice of Reproductive Science and
Diagnostic Semen Analysis
Introduction to Principles and Practice of Histopathology
Principles and Practice of Cervical Cytology and
Diagnostic Cytopathology
Genetics and Molecular Science
Duration: Each rotation should be of approximately 12 weeks duration.
Order: It is expected that the first rotation completed will be Reproductive Science.
ELECTIVE COMPONENT
The elective period can be taken any time during the specialist training. It may
comprise a single 4- to 6-week elective or a series of shorter periods of elective
training.
SPECIALIST COMPONENT
Module 1 (RS-2)
Infertility, Treatment and Role of Regulation
Module 2 (RS-3)
Gametes and Fertilisation
Module 3 (RS-4)
Culture of Gametes and Embryos
Module 4 (RS-5)
Micromanipulation and Cryopreservation
Module 5 (RS-6)
Embryology
Duration: The work based component of the five specialist modules should be
completed during the specialist training period. The work based component of the
modules can run in parallel in order to use the time and clinical contacts to best
advantage.
The following sections of the learning guide contain the learning frameworks
for the rotational, elective, specialist and professional practice modules.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
Cellular Sciences
SECTION 3: ROTATIONAL LEARNING FRAMEWORKS
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
STP Learning Framework
This section describes the Learning Framework for the Rotational Component of work based
learning covering the Learning Outcomes, Clinical Experiential Learning, Competence and
Applied Knowledge and Understanding. Each trainee is also expected to build on and apply the
knowledge, skills and experience gained from the MSc in Clinical Science.
Rotational Modules
DIVISION
Life Sciences
THEME
Cellular Sciences
SPECIALISM
Cytopathology
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
MODULE
TITLE
AIM
SCOPE
Principles and Practice of Cervical Cytology
and Diagnostic Cytopathology (CP-1)
COMPONENT
Rotation
This module will provide trainees with the knowledge and understanding of Cervical Cytology and an overview
of the role and limitations of Diagnostic Cytopathology.
Trainees will be able to recognise normal cells in cervical cytology preparations. They will gain knowledge of
the cervical screening programme, the role of fine needle aspiration cytology and non-gynaecological cytology
preparation techniques.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
1.
2.
3.
4.
Receive, prepare and process specimens for cytopathological investigation.
Select appropriate methods for preparation, fixation and staining
Use microscopic examination techniques on a selection of cytopathology samples.
Recognise the appearance of normal and abnormal cellular patterns in Cervical Cytology.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
CLINICAL EXPERIENTIAL LEARNING
The clinical experiential learning for this module is:
•
•
•
•
•
•
Participate in multidisciplinary review meetings at which cytopathology results are presented as part of the clinical record.
Reflect and discuss in terms of the benefits of a multidisciplinary approach to patient care and the importance for the patient
pathway.
Review and discuss the application of the range of cytochemical, immunocytochemical and molecular techniques available in
the training department, including application to non-gynaecological specimens.
Review, reflect on and discuss the operation of current cervical screening programmes, with particular reference to their
importance to patient groups, to identification and prevention of disease and to the patient pathway.
Review and discuss the application and interpretation of quality assurance methodologies in Cytopathology.
Discuss with practitioners the preparation and interpretation of cytopathological reports. Reflect and report on the importance
and implications of effective reporting.
Undertake a range of work activities that involve working in partnership between the cytopathology laboratory and other
clinical specialisms in the investigation of disease. Reflect and report on the importance of this partnership approach to the
patient experience of investigation, treatment and management.
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional
practice competences alongside the competences defined in this module.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
KEY
LEARNING
OUTCOMES
1
COMPETENCES
Receive, label and store a wide
range of cytopathology specimens.
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
•
•
2
Prepare, select and use appropriate
fixative and staining solutions to a
variety of tissue samples, to include:
• Papanicolaou and MayGrünwald-Giemsa staining
technique.
•
•
•
•
•
•
3
Set up and use light microscopy at
various magnifications levels to
•
Minimum data set required for identification of samples and the
importance of ensuring that this is complete and correct.
Factors affecting sample integrity and appropriate corrective action.
Procedures for handling samples which may contain category 2, 3 and
4 pathogens.
Relevant records, their importance and how to complete these
correctly.
Types and implications of hazards and risks associated with handling
of cytopathology specimens and relevant control measures.
Correct location and storage of documentation and specimens at each
stage of processing.
Types and implications of hazards and risks associated with handling
of specimens and relevant control measures.
The quality management process that ensures the correct location and
storage of documentation and specimens at each stage of the
process.
Types, purposes and use of fixatives, preservatives, stains and
equipment associated with specimen preparation and processing.
Potential hazards and risks associated with specimen preparation and
associated control measures.
Principles of liquid-based cytology and imaging technologies.
Principles of non-gynaecological cytology preparation techniques.
Special stains used to aid diagnosis relevant to cytology, including
Grocott and Ziehl–Neelsen (ZN).
Relevant statutory, regulatory and legislative requirements and
guidance associated with processing of specimens.
The function of microscopic components and how to set up a
microscope for investigation of cytopathology specimens.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
KEY
LEARNING
OUTCOMES
2
COMPETENCES
investigate a range of cytopathology
specimens.
Select the appropriate enzyme
cytochemical techniques required to
demonstrate a specific disease
process using appropriate control
material.
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
2
4
4
Select the appropriate
immunocytochemical techniques
and antibodies to demonstrate a
specific disease process using
appropriate control material
•
•
•
•
Based on representative cervical
cytology specimens, identify normal
cellular appearance under the
microscope and be able to
recognise commonly occurring
pathological features.
•
•
Produce a basic interpretative report
on cytopathology investigations.
•
•
•
•
•
Relevance and importance of specificity, sensitivity, accuracy and
precision in the evaluation of analytical methods.
Capabilities and limitations of methods, techniques and equipment.
Safe laboratory practices, including principles of sterilisation and
decontamination.
Principles and applications of techniques using different
instrumentation.
Use and application of reagents for analysis.
Significance of standard operating procedures (SOPs), internal quality
control (IQC) and external quality assessment (EQA).
Factors that influence the quality and integrity of prepared specimens.
The range of further investigations that may be required, their
purpose, capabilities and limitations.
Factors that influence the quality and integrity of prepared specimens.
The range of further investigations that may be required, their
purpose, capabilities and limitations.
How to recognise common pathological features of dyskaryosis,
cervical glandular intraepithelial neoplasia and common infections
seen in cervical samples.
The information to be included in an interpretative report.
How to construct an interpretative report and the format required for
presentation.
Limits of responsibility in the authorisation and issue of interpretative
reports.
Clinical conditions that may require urgent action and how to instigate
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
KEY
LEARNING
OUTCOMES
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
•
1,2,3
Control infection risks in accordance
with departmental protocols.
•
•
1,2,3
Minimise risks and hazards in
compliance with health and safety
policies.
•
•
•
•
such action.
Normal and abnormal results and their significance to the clinical
question or condition.
Protocols and requirements for hygiene and infection control related to
the relevant range of investigations, including preparation, conduct
and completion of investigation.
Protocol for hand washing and how effective hand washing contributes
to control of infection.
The relevant health and safety regulations for laboratory and clinical
investigations.
The specific health and safety regulations for the specialism, type of
specimen/sample and investigation.
The potential hazards and risks and the actions to be taken to
minimise these.
Responsibilities and scope of practice of laboratory personnel involved
in performing investigations and reporting those investigations to
users.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
STP Learning Framework
This section describes the Learning Framework for the Rotational Component of work based
learning covering the Learning Outcomes, Clinical Experiential Learning, Competence and Applied
Knowledge and Understanding. Each trainee is also expected to build on and apply the
knowledge, skills and experience gained from the MSc in Clinical Science.
Rotational Modules
DIVISION
Life Sciences
THEME
Cellular Sciences
SPECIALISM
Histopathology
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
MODULE
TITLE
AIM
SCOPE
Introduction to Principles and Practice of
Histopathology (HP-1)
COMPONENT Rotation
This module will provide trainees with the knowledge and understanding of the principles and practice of
Histopathology as applied to clinical medicine.
Trainees will use a range of histological techniques and gain experience of interpreting results from patient
investigations.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
1. Receive, prepare and process specimens for histopathological investigation. To include dissection, tissue selection cutting,
fixation and staining as appropriate.
2. Select the appropriate demonstration technique in the investigation of representative histopathology specimens.
3. Use microscopic examination techniques to investigate histopathological specimens.
4. Recognise normal cellular morphology of representative tissues and organs and common pathobiological processes associated
with them.
5. Comply with quality assurance processes associated with histopathological investigations.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
CLINICAL EXPERIENTIAL LEARNING
The clinical experiential learning for this module is:
• Participate in multidisciplinary review meetings at which histopathology results are presented as part of the clinical record.
Reflect and report on the importance of a multidisciplinary approach to patient investigation, treatment and management.
• Review, discuss and report on the application of the range of histochemical, immunocytochemical and molecular techniques
available in the training department.
• Observe, review and discuss the application and interpretation of quality assurance methodologies in Histopathology.
• Discuss, with practitioners, the preparation and reporting of FRCPath category A, B and C specimens.
• Undertake activities that demonstrate the partnership between the histopathology laboratory and other clinical specialisms in the
investigation of disease. Reflect on your experiences and the implications for patient investigation, treatment and care
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional
practice competences alongside the competences defined in this module.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
KEY
LEARNING
OUTCOMES
1,5
COMPETENCES
Receive, label and store of a wide
range of histopathology specimens.
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Minimum data set required for identification of samples and the
importance of ensuring that this is complete and correct.
Factors affecting sample integrity and appropriate corrective action.
Procedures for handling samples which may contain category 2, 3
and 4 pathogens.
Types and implications of hazards and risks associated with
handling of specimens and relevant control measures.
The quality management process that ensures the correct location
and storage of documentation and specimens at each stage of the
process.
Legal and ethical considerations and requirements in respect of
examination of tissue, selection of control material and disposal of
specimens.
Infection risk from blood samples and how to deal with fresh tissue
samples.
Safe laboratory practices, including principles of decontamination of
equipment and work areas.
Specimen acquisition, viability, collection and delivery, including
renal biopsies and bullous skin diseases.
Quality assurance procedures and their application.
Local and national health and safety policies and procedures and
their application.
The range of imaging procedures available and their use, including
storage of images.
Correct and safe use of imaging equipment and processing of Xrays or photographic films if required.
The dissection of FRCPath category A, B and C specimens.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
KEY
LEARNING
OUTCOMES
1
COMPETENCES
Prepare and use a microtome on a
range of tissue samples within
different embedding materials.
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
•
•
•
•
•
2
2
2
Apply the haematoxylin and eosin
staining technique to a variety of
tissue samples.
Select the appropriate tinctorial
and/or histochemical staining
techniques required to demonstrate
a specific disease process using
appropriate control material.
Select the appropriate impregnation
techniques required to demonstrate
a specific disease process using
•
•
•
•
•
•
Principles and practice of fixation.
Principles of specimen dissection and block selection.
Tissue processing and embedding techniques.
Decalcification.
Microtomy, cryotomy.
Macrophotography.
Normal cellular morphology and ultrastructure of specified tissues
and organ systems, including skin, building on basic anatomy and
physiology.
Basic principles of tissue preparation techniques, including factors
affecting selection and their application.
Factors that influence the quality and integrity of prepared
specimens.
The principles of specimen dissection and manipulation to expose
features of interest.
Basic principles of demonstration techniques and their rationale and
hazards.
Haematoxylin and eosin staining techniques and their application.
Special stains to identify individual tissue/cellular components, e.g.
connective tissues, nucleic acids, mucins, lipids, pigments.
Histochemical techniques and their application.
Potential artefacts, their identification and importance.
The range of tinctorial and histochemical staining techniques, their
selection and application to disease processes.
The range of control materials and their appropriate use.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
KEY
LEARNING
OUTCOMES
COMPETENCES
appropriate control material.
KNOWLEDGE AND UNDERSTANDING
•
•
•
3
4
4
4
1,2,3,4
Set up and use light microscopy at
various magnifications in the
investigation of a range of tissue
specimens.
Select the appropriate enzyme
histochemical techniques required
to demonstrate a specific disease
process using appropriate control
material.
Select the appropriate
immunohistochemical and/or
immunofluorescence techniques
and antibodies to demonstrate a
specific disease process using
appropriate control material.
Select the appropriate molecular
techniques, markers and reagents
required to demonstrate a specific
disease process using appropriate
control material.
Produce a basic interpretative
report on histopathology
investigations.
Capabilities and limitations of methods, techniques and equipment.
Principles and applications of techniques using different
instrumentation.
Correct use and application of reagents for analysis.
•
The function of microscopic components and how to set up a
microscope for investigation of histopathology specimens.
•
Histochemical techniques and their application.
•
The principles and common application of immunohistochemistry
and immunofluorescence.
•
The principles and common application of molecular techniques in
Histopathology.
•
The components required for a histopathology report and their
relevance to patient care.
The information to be included in an interpretative report.
How to construct an interpretative report and the format required for
•
•
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
KEY
LEARNING
OUTCOMES
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
1,2,5
Control infection risks in
accordance with departmental
protocols.
•
•
1,2,5
Minimise risks and hazards in
compliance with health and safety
policies.
•
•
•
•
presentation.
Limits of responsibility in the authorisation and issue of
interpretative reports.
Clinical conditions that may require urgent action and how to
instigate such action.
Normal and abnormal results and their significance to the clinical
question or condition.
Relevance and importance of specificity, sensitivity, accuracy,
precision and linearity in the evaluation of analytical methods.
The range of further investigations that may be required, their
purpose, capabilities and limitations.
Protocols and requirements for hygiene and infection control related
to the relevant range of investigations, including preparation,
conduct and completion of investigation.
Protocol for hand washing and how effective hand washing
contributes to control of infection.
The relevant health and safety regulations for laboratory and clinical
investigations.
The specific health and safety regulations for the specialism, type of
specimen/sample and investigation.
The potential hazards and risks and the actions to be taken to
minimise these.
Responsibilities and scope of practice of laboratory personnel
involved in performing investigations and reporting those
investigations to users.
Page | 43
STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
STP Learning Framework
This section describes the Learning Framework for the Rotational Component of work based
learning covering the Learning Outcomes, Clinical Experiential Learning, Competence and Applied
Knowledge and Understanding. Each trainee is also expected to build on and apply the
knowledge, skills and experience gained from the MSc in Clinical Science.
Rotational Module
DIVISION
Life Sciences
THEME
Cellular Sciences
SPECIALISM
Reproductive Science
Page | 44
STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
MODULE
TITLE
AIM
SCOPE
Principles and Practice of Reproductive
Science and Diagnostic Semen Analysis
(RS-1)
COMPONENT Rotation
This module will provide trainees with the knowledge and understanding of the normal physiology of the male
and female reproductive tracts. The trainees will gain an insight into the in vitro fertilisation patient pathway.
Trainees will be able to perform diagnostic semen analysis and recognise how the differing semen parameters
relate to clinical treatment. They will gain knowledge of current legislation and regulations and will be able to
apply appropriate standards of health and safety and perform to expected standards.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
1.
2.
3.
4.
5.
Apply and interpret quality assurance methodologies in reproductive science.
Apply health and safety methodologies and practices appropriate to the reproductive science laboratory.
Perform to accepted standard relevant techniques for semen analysis and preparation.
Prepare, interpret and report on diagnostic semen analysis (under supervision).
Work in partnership with the reproductive science laboratory and other clinical specialisms in the investigation of infertility.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
CLINICAL EXPERIENTIAL LEARNING
The clinical experiential learning for this module is:
•
•
•
•
•
•
•
Participate in multidisciplinary team meetings at which a range of relevant clinical cases and/or procedures are discussed.
Review and discuss the patient pathway through the treatment process and the benefits of a multidisciplinary approach.
Visit a clinical biochemistry laboratory. Review and discuss the methods used for the measurement and reporting of
reproductive hormones.
Attend infertility clinics and assisted conception units. Review and report on their role and importance in the patient pathway.
Observe work activities with specific reference to embryology procedures from egg collection to embryo transfer (including in
vitro fertilisation [IVF], intracytoplasmic sperm injection [ICSI], embryo culture, embryo freezing and thawing) and theatre
procedures (including egg collection and embryo transfer), and review these procedures in relation to the patient journey
through investigation and treatment.
Observe follicular and clinical pregnancy scanning to follow the patient pathway and understand how monitoring is carried out
in a controlled ovarian stimulation regimen.
Observe, participate and review the application and interpretation of quality assurance methodologies in Reproductive Science.
Review and discuss the preparation, interpretation and reporting of diagnostic semen analysis.
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional practice
competences alongside the competences defined in this module.
Page | 46
STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
KEY
LEARNING
OUTCOMES
1,2,5
COMPETENCES
Receive, process and store samples
for analysis.
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
•
•
•
•
•
•
3
1,2,3
Set up and use relevant
microscopes. To include optical
principles, maintenance and clinical
applications.
Measure semen volume, extent of
liquefaction and appearance.
•
•
•
Minimum data set required for identification of samples and the
importance of ensuring that this is complete and correct.
The importance of patient confidentiality and how this is maintained.
Factors affecting sample integrity and appropriate corrective action.
Instructions that need to be provided to patients pre sample.
Procedures for handling samples which may contain category 2, 3
and 4 pathogens.
Types and implications of hazards and risks associated with
handling of specimens and relevant control measures.
The quality management process that ensures the correct location
and storage of documentation and specimens at each stage of the
process.
Legal and ethical considerations and requirements in respect of
handling and processing samples in Reproductive Science.
Infection risk from samples and how to deal with fresh tissue
samples.
Safe laboratory practices, including principles of decontamination of
equipment and work areas.
Quality assurance procedures and their application.
Local and national health and safety policies and procedures and
their application.
The function of microscopic components and how to set up a
microscope for investigation of reproductive specimens.
Normal male and female reproductive anatomy and physiology.
Current legislation and regulation as it applies to Reproductive
Science.
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KEY
LEARNING
OUTCOMES
1,2,3
1,2,3
3,4
3,4
4
COMPETENCES
Perform repeated sperm counts for
concentration and motility using the
same semen sample and be able to
explain the variation observed.
Perform diagnostic sperm counts for
concentration and motility on
different patients and be able to
prepare reports for discussion with
your supervisor.
Identify normal and abnormal
semen samples. To include sperm
concentration, motility assessment,
morphology, anti-sperm antibody
testing, sperm viability testing.
Perform gradient and swim-up
techniques for the preparation of
semen samples for treatment.
Produce a record of reports seen
and discussed with your supervisor.
KNOWLEDGE AND UNDERSTANDING
•
•
•
Principles of and standards for diagnostic semen analysis.
Characteristics of normal and abnormal semen samples.
Semen preparation, including different methodologies, diagnostic
tests and functional tests.
•
•
•
•
•
•
•
Characteristics of normal and abnormal semen samples.
Hormonal control of male reproduction.
Reasons for referral.
Causes of and treatments for infertility.
The anatomy and physiology of the male reproductive tract.
SSR (surgical sperm retrieval).
The advantages and disadvantages of different methodologies used
for the preparation of sperm.
•
Requirements for records and reports of investigations in
Reproductive Science.
How to construct an interpretative report and the format required for
presentation.
Limits of responsibility in the authorisation and issue of
interpretative reports.
Clinical conditions that may require urgent action and how to
instigate such action.
Normal and abnormal results and their significance to the clinical
question or condition.
•
•
•
•
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KEY
LEARNING
OUTCOMES
2,3
COMPETENCES
Control infection risks in accordance
with departmental protocols.
KNOWLEDGE AND UNDERSTANDING
•
•
2,3
Minimise risks and hazards in
compliance with health and safety
policies.
•
•
•
•
•
•
Protocols and requirements for hygiene and infection control related
to the relevant range of investigations, including preparation,
conduct and completion of investigation.
Protocol for hand washing and how effective hand washing
contributes to control of infection.
The relevant health and safety regulations for laboratory and clinical
investigations.
The specific health and safety regulations for the specialism, type of
specimen/sample and investigation.
The potential hazards and risks and the actions to be taken to
minimise these.
Use and maintenance of centrifuges.
Responsibilities and scope of practice of laboratory personnel
involved in performing investigations and reporting those
investigations to users.
The patient pathway through a treatment cycle.
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STP Learning Framework
This section describes the Learning Framework for the Rotational Component of work based
learning covering the Learning Outcomes, Clinical Experiential Learning, Competence and
Applied Knowledge and Understanding. Each trainee is also expected to build on and apply the
knowledge, skills and experience gained from the MSc in Clinical Science.
Rotational Module
DIVISION
Life Sciences
THEMES
Blood and Cellular Sciences
SPECIALISM
Genetics and Molecular Science
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MODULE
TITLE
AIM
SCOPE
Genetics and Molecular Science (CG-1)
COMPONENT Rotation
This module will provide the trainee with an introduction to human Genetics and Molecular Science.
They will understand the organisation and delivery of a genetics laboratory service. They will perform
some common methods used in Genetics and gain an understanding of the interpretation of patient
results in a variety of clinical settings.
The investigation, interpretation and reporting of chromosomal abnormality and molecular disease,
using the correct sampling and laboratory techniques, and including the application of principles of
quality control and the use of IT systems.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
1. Assist with the investigation of chromosomal abnormality, the correct sampling technique and the use of the International
System for Chromosome Nomenclature (ISCN).
2. Play a supporting role in cell culture, slide making and G-band staining techniques used in the investigation of chromosome
anomalies.
3. Assist with the investigation of the molecular basis of disease, the correct sampling technique and relevant quality parameters.
4. Perform DNA extraction technique, polymerase chain reactions (PCRs) and observe sequencing reactions used in the
investigation of the molecular basis of disease.
5. Apply the principles of internal quality control and external quality assessment and draw conclusions about assay performance.
6. Assist with the interpretation and reporting of laboratory results in the context of named genetic disorders.
7. Participate in activities that involve working in partnership with other clinical specialisms in the investigation of genetic
disorders.
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CLINICAL EXPERIENTIAL LEARNING
The clinical experiential learning for this module is:
•
•
•
•
Attend multidisciplinary team meetings at which the results of genetic investigations are discussed, and reflect on discussions
and the impact of multidisciplinary working on patient treatment and management.
Attend specialist genetics clinics and review/report on the process, patient engagement and experience in connection with the
work of these clinics.
Observe cell culture and chromosome preparation techniques and reflect on their importance in the investigation process.
Gain experience of each of the following and personally reflect on the importance, application and effect on patient
management:
•
investigation of chromosomal abnormality, the correct sampling technique and the use of ISCN
•
investigation of the molecular basis of disease, the correct sampling technique and relevant quality parameters
•
interpretation and reporting of laboratory results in the context of named genetic disorders
•
the partnership between Genetics and other clinical specialisms in the investigation of genetic disorders.
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional
practice competences alongside the competences defined in this module.
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KEY
COMPETENCES
LEARNING
OUTCOMES
1,3,5
Receive, label and store specimens
for chromosome investigation and
understand referral patterns.
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
•
•
•
•
1
Perform a basic chromosome
analysis on a minimum of five
cases that demonstrate different
chromosomal syndromes or
anomalies.
•
•
•
•
2
Perform a basic chromosome
analysis using microscopy and
digital imaging.
•
3
Receive, label and store specimens
•
•
Minimum data set required for identification of samples and the
importance of ensuring that this is complete and correct.
Factors affecting sample integrity and appropriate corrective action.
Procedures for handling samples which may contain category 2, 3,
and 4 pathogens.
Use of laboratory and hospital information systems to identify and
record patient demographics, clinical details and relevant laboratory
results.
How to generate a unique sample identifier.
The importance of maintaining correct and unique labelling, including
transfer of labels throughout the preparation.
Process documentation relevant to sample preparation and its
importance.
Retention policy for diagnostic materials and records of analysis.
Ethical guidelines for storage of diagnostic materials.
An understanding of the common reasons for referral for
chromosome investigations.
Basic chromosome identification.
Karyotype construction.
Numerical and structural anomalies and normal variation.
Relationship of basic chromosomal anomalies to clinical features in
patients.
Procedures for manual, digital and photographic storage and
retrieval of data from chromosome investigations.
The reasons for referral for molecular diagnostic testing.
Minimum data set required for identification of samples and the
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KEY
LEARNING
OUTCOMES
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
for molecular diagnostic testing.
•
•
•
•
•
1,2,3,4
Perform both manual and/or
automated DNA extraction
techniques (to be performed after
observation).
•
•
•
•
•
•
•
•
•
3
Observe and perform PCRs and
observe a basic sequencing
reaction and fragment analysis.
•
•
•
•
•
importance of ensuring that this is complete and correct.
Factors affecting sample integrity and appropriate corrective action.
Procedures for handling samples which may contain category 2,3,
and 4 pathogens.
Use of laboratory and hospital information systems to identify and
record patient demographics, clinical details and relevant laboratory
results.
How to generate a unique sample identifier.
The importance of maintaining correct and unique labelling, including
transfer of labels throughout the preparation process.
Documentation relevant to sample preparation and its importance.
The common reasons for referral for molecular testing.
Policy for authorisation and disclosure of results.
The purpose, process, capabilities and limitations of extraction
procedures and associated equipment.
Relevant protocols and their application, including health and safety
considerations.
Requirements for containment levels.
The quality and quantity of DNA/RNA required for each test to be
performed.
Factors affecting the quality of extractions.
The range and requirements for records and documentation
associated with extractions.
Correct mutation nomenclature.
Principles and applications of relevant methods and techniques.
The principles of PCR.
The significance of contamination and sensitivity of PCR.
Hazards and risks associated with PCR.
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KEY
LEARNING
OUTCOMES
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
4
Perform a basic molecular analysis
on five cases demonstrating
common molecular genetics
syndromes.
•
•
•
•
•
•
•
•
•
•
•
•
•
•
5
Apply internal quality control (IQC)
and external quality assessment
(EQA) methods used in
cytogenetics and molecular
genetics.
6
Apply microcomputer software for
•
tasks related to Genetics. To include
Relevant current quality control procedures.
Characteristics of substandard reactions.
Factors affecting the integrity of samples and reagents, including
liability and contamination.
Factors affecting integrity of reagents used in the tests conducted
and relevant sensitivities to conditions of cold, heat and light.
Principles of electrophoresis of nucleic acids.
Principles of radioactive and fluorescent image detection.
Principles of mutation detection and DNA sequencing.
Limitations and sensitivity of each test method.
The nature and effect of possible artefact.
Analysis of results using standard laboratory processes.
Ethical guidelines for testing.
The clinical background and molecular pathology of the disorder
being investigated.
The range of tests available for the individual or the family.
Professional and local guidelines for tests appropriate to each
disorder.
Significance of previous results in relation to the current sample.
Relevant professional guidelines and correct interpretation.
The importance of IQC during the testing process.
Importance of EQA.
Access, use and limitations of Online Mendelian Inheritance in Man
(OMIM), genome and mutation databases.
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KEY
LEARNING
OUTCOMES
COMPETENCES
an introduction to bioinformatics.
KNOWLEDGE AND UNDERSTANDING
•
•
7
Support the preparation of reports
and the reporting process for
patients being investigated for
named genetic disorders.
•
•
•
•
•
•
1,2,3,4
Control infection risks in accordance
with departmental protocols.
•
•
•
1,2,3,4
Minimise risks and hazards in
compliance with health and safety
policies.
•
•
•
•
Importance of maintaining long-term records because of implications
for heritable genetic disorders to future generations, and genomic
changes within an individual associated with a clinical disorder.
Limits and performance characteristics of each test, including
instrumentation and software packages for data analysis.
Range of reporting formats and options.
Relevant professional guidelines for reporting.
Policy for authorisation and disclosure of results.
Factors involved in evaluation of clinical risk to the patient and their
family.
Procedures for issuing written results, verbal results, or for faxing.
Patterns of inheritance (Mendelian and non-Mendelian), including
imprinting.
Requirements for disclosure and confidentiality.
Protocols and requirements for hygiene and infection control related
to the relevant range of investigations, including preparation, conduct
and completion of investigation.
Protocol for hand washing and how effective hand washing
contributes to control of infection.
The relevant health and safety regulations for laboratory and clinical
investigations.
The specific health and safety regulations for the specialism, type of
specimen/sample and investigation.
The potential hazards and risks and the actions to be taken to
minimise these.
Responsibilities and scope of practice of laboratory personnel
involved in performing investigations and reporting those
investigations to users.
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Cellular Sciences
SECTION 4: PROFESSIONAL PRACTICE LEARNING FRAMEWORK
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STP Learning Framework
This section describes the Learning Framework for the Professional Practice Component of work
based learning covering the Learning Outcomes, Clinical Experiential Learning, Competence, and
Applied Knowledge and Understanding. This module spans the Rotational and Specialist period of
training. Each trainee is also expected to build on and apply the knowledge, skills and experience gained
from the MSc in Clinical Science
PROFESSIONAL PRACTICE
DIVISION
Life Sciences, Physiological Sciences, Physical Sciences
and Biomedical Engineering
THEME
ALL
SPECIALISM
ALL
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
Introduction
Good Scientific Practice (GSP) sets out the principles and values on which good practice undertaken by the Healthcare Science
workforce is founded. GSP sets out for the profession and the public the standards of behaviour and practice that must be achieved
and maintained in the delivery of work activities and the provision of care. GSP uses as a benchmark the Health Professions
Council (HPC) Standards of Proficiency and Standards of Conduct, Performance and Ethics, but expresses these in the context of
the modalities within Healthcare Science.
Good Scientific Practice represents standards and values that apply throughout an individual’s career in Healthcare Science at any
level of practice. Therefore the standards have been contextualised for the role of healthcare scientist. There will, however, always
be a requirement for an individual to work within the limits of their scope of practice and competence.
Professional Practice in the STP Training Programme
This generic professional practice module, which all STP trainees have to complete, defines the knowledge, skills and experience
that each trainee is expected to gain and apply during the STP programme and develop in subsequent employment. The degree to
which each specialism applies the knowledge, skills and experience will vary, but this module sets the baseline for all trainees.
Each rotational and specialist learning framework then develops areas as appropriate, for example clinical history taking in patientfacing specialisms.
While it is expected that trainees will be able to achieve the majority of the learning outcomes and competences within their
specialism, some specialisms may have to make special arrangements to ensure all trainees achieve the learning outcomes and
competences defined in this learning framework. For example, to work with a local clinical skills laboratory to help trainees develop
basic skills in history taking.
The Learning Framework that defines the learning outcomes, clinical experiential learning, competences, and knowledge and
understanding are contained on the following pages.
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COMPONENT
GENERIC
MODULE Professional Practice (PP1)
TITLE
Professional Practice is part of the generic curriculum (applicable to all trainees) on the Scientist Training
AIM
SCOPE
Programme. The overall aim of the module is to ensure that each trainee has the underpinning knowledge and
applies this and the accompanying skills and attitudes to work as a healthcare scientist in accordance with Good
Scientific Practice (GSP).
GSP sets out the principles and values on which the practice of Healthcare Science is undertaken. It sets out for the
profession and the public the standards of behaviour and practice that must be achieved and maintained in the
delivery of work activities and the provision of care. This module encompasses the knowledge, skills, experience and
attitudes across four of the five domains of Good Scientific Practice, namely Professional Practice, Scientific Practice,
Clinical Practice, Research and Development, and Clinical Leadership, but all other modules within this programme
will contribute to embedding professional practice at the centre of the work of each trainee.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
Professional Practice
1. Place the patient at the centre of care in daily practice, ensuring the needs of patients are respected.
2. Communicate with patients, relatives, service users, other healthcare professionals, colleagues and the public with respect,
empathy and sensitivity, including listening, speaking, giving and receiving information, giving and receiving feedback.
3. Respond to the ethical and legal issues and challenges arising from the practice of Healthcare Science.
4. Demonstrate a commitment to the continuing professional development of themselves and others, and attend professional
meetings.
Clinical Practice
5. Make appropriate and effective use of information and communication technology.
6. Under supervision, obtain a patient history from a normal volunteer or typical patient referred to your service and present the
findings to a colleague or peer in order to understand the clinical decision-making process in clinical practice.
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7. Promote the importance of patient safety and general health, safety and security in the workplace, including infection control
and information governance.
Research, Development and Innovation
8. Apply knowledge, skills and experience of research, development and innovation appropriate to the role in order to identify
effectively actions that will improve service provision.
9. Engage in evidence-based practice, participate in audit procedures and critically search for, appraise and identify innovative
approaches to practice and delivery.
Clinical Leadership
10. Demonstrate a range of leaderships skills required of an emerging leader within Healthcare Science.
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CLINICAL EXPERIENTIAL LEARNING
The clinical experiential learning for this module is:
•
•
•
Attend clinics, ward rounds, treatment and/or rehabilitation sessions, etc., in primary or secondary care, or in the charity or
voluntary sector where patients attend, and observe how patient–professional relationships are developed and maintained,
and reflect on how the following impact on the patient–professional relationship:
•
response to illness
•
patient and carer perspective
•
health belief models
•
diversity of the patient experience
•
disability, including learning disabilities
•
potential health inequalities
•
self-care
•
impact of life-threatening and critical conditions
•
patient involvement in decisions regarding their healthcare.
Observe a current screening programme in the workplace and discuss the principles and practice of screening programmes
in healthcare as a means of reducing disease burden with your training officer.
Observe and participate in internally and externally accredited quality management systems and critically appraise both in
your area of practice.
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
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KEY
LEARNING
OUTCOMES
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
Professional Practice
1
1
2
Treat each patient as an
individual, respecting their
dignity and confidentiality and
upholding the rights, values
and autonomy of every
service user.
Discuss personal values,
principles and assumptions,
emotions and prejudices, and
how these may influence
personal judgement and
behaviour, and identify how
you will practise in
accordance with Good
Scientific Practice.
Communicate effectively with
the public, services users and
other healthcare
• NHS Constitution.
• Patient-centred care and the patient carer perspective with respect to:
response to illness
•
patient and carer perspective
•
health belief models
•
diversity of the patient experience
•
disability, including learning disabilities
•
potential health inequalities
•
self-care
•
impact of life-threatening and critical conditions
•
patient involvement in decisions regarding their healthcare.
• Local guidelines for responding to unacceptable behaviour by patients, carers,
relatives, peers and colleagues, including harassment, bullying and violent
behaviour.
• Good Scientific Practice.
• The importance of maintaining own health.
•
• The principles of effective communication including:
•
•
written and electronic, verbal and non-verbal and feedback
the way effective communication can assist in identifying problems accurately,
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KEY
LEARNING
OUTCOMES
COMPETENCES
professionals, adapting
communication style and
language to meet the needs
of listeners.
2
Give and receive feedback
sensitively to or from a peer
or colleague.
2
Obtain, analyse and act on
feedback from a variety of
sources and use it to
consider personal impact and
change behaviour.
Present complex ideas in
understandable terms in both
oral and written formats.
2
KNOWLEDGE AND UNDERSTANDING
increase patient satisfaction, enhance treatment adherence, and reduce
patient distress and anxiety
•
the importance of some key ideas, for example signposting, listening,
language, non-verbal behaviour, ideas, beliefs, concerns, expectations and
summarising in communication
•
the range of question types that can be used in a communication.
• The range of feedback models for giving and receiving feedback.
• The evidence base underpinning the importance of effective feedback/feedback
models.
• How to analyse feedback and frameworks for action planning.
• Behavioural change models.
• The importance of public engagement in science and its role in health and
society.
• The factors that enable scientists to communicate to specialist and non-specialist
audiences.
2
2
3
Use effective negotiation
skills, including influencing
colleagues.
Work constructively and
effectively as a member of a
multidisciplinary team.
Comply with relevant
guidance and laws, to include
those relating to:
• Barriers to effective communication.
• Communication channels with/in your host department; patients and the public;
your employing institution; your profession and professional body; the wider
Healthcare Science community.
• The underpinning principles of effective teamwork and working within and across
professional boundaries.
• Principles, guidance and law with respect to:
•
•
medical ethics
confidentiality
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KEY
LEARNING
OUTCOMES
COMPETENCES
•
•
•
•
•
•
•
4
4
4
4
4
your scope of practice
research ethics and
governance
patient confidentiality
data protection
equality and diversity
use of chaperones
informed consent.
Contribute to the education
and training of colleagues.
Take responsibility for your
learning and demonstrate a
commitment to continuing
professional development.
Meet commitments and goals
in your professional practice,
using a range of
organisational and planning
tools.
Reflect on your practice and
generate a reflective diary
that demonstrates how you
utilise the skills required of an
independent learner and your
commitment to your
continuing professional
development.
Take responsibility for
KNOWLEDGE AND UNDERSTANDING
information governance
•
informed consent
•
equality and diversity
•
child protection
•
elder abuse
•
use of chaperones
•
probity
•
fitness to practise.
•
The importance of maintaining your own health.
• The key principles and evidence base underpinning clinical education,
encompassing curriculum design, planning, delivery and assessment.
• How continuous personal development can improve personal performance.
•
• Different methods of planning, prioritising and organising, and how they can
enhance personal effectiveness.
• Core theories of learning, particularly adult learning and reflective practice, and
demonstrate how these are relevant to your practice as a healthcare scientist.
• Personal values, principles and assumptions, emotions and prejudices,
understanding how these may influence personal judgement and behaviour.
• The role of critical reflection and reflective practice and the methods of reflection
that can be used to maintain or improve knowledge, skills and attitudes.
• How to horizon scan, identify and evaluate the potential role for new and
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KEY
LEARNING
OUTCOMES
4
COMPETENCES
keeping your professional
and scientific knowledge
and skills up to date.
Develop an action plan
based on your experiential
learning and reflection on
completion of the Scientist
Training Programme.
KNOWLEDGE AND UNDERSTANDING
innovative technologies and scientific advances.
• Action planning.
• Models and frameworks for critical reflection.
Clinical Practice
5
6
Use a range of information
and communication
technologies within the
workplace for service
delivery, research, audit and
innovation, including data
filing and archiving:
• word processing
• databases
• statistics packages
• PowerPoint
• internet
• email.
Under supervision,
demonstrate that you can
obtain and present a
patient history from a
normal volunteer or
• The range and application of clinical information systems used in the work base.
• The systems in use in the work base to file and archive information and the
processes for retrieval.
• The principles underpinning identification, storage and retrieval of scientific
literature for example end note/end note web.
• The purpose of a range of NHS information systems, including the regulations in
place to ensure data security and confidentiality. This may include hospital
information system, linked information systems (e.g. laboratory information
management system) and middleware linking equipment to information systems.
• The importance of patient-centred care and how it ensures that the wishes,
beliefs, concerns, expectations and needs of patients are respected.
• Patient and carer perspective with respect to illness, disability, health inequalities
and diversity of the patient experience.
• Structured models for presenting a patient history.
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KEY
LEARNING
OUTCOMES
7
7
COMPETENCES
consenting patient in order
to better understand the
clinical decision-making
process in your clinical
practice.
Apply current regulations
with respect to patient safety
and safe systems within the
workplace. To include, as
appropriate to scope of
practice:
• risk management
• biological specimen
handling
• COSHH
• RIDDOR
• radioactivity
• fire safety
• electrical safety
• moving and handling
• display screen
equipment
• incident reporting
• infection control.
Use clinical coding and
medical terminology in
accordance with stated
guidance, as appropriate to
KNOWLEDGE AND UNDERSTANDING
• Process of patient-centred interviewing and the features of a good consultation,
•
•
•
•
•
•
•
•
including Initiating the session, gathering information, building the relationship,
explaining and planning, and closing the session.
Link between the patient history and examination and development of clinical
investigation and management plans.
The importance of health and safety within the workplace, wider healthcare
environment and NHS.
Principles, process and governance of risk management.
Factors influencing health, safety and security.
Current legislation, codes of practice, guidance notes and related documents.
Principles and practice of health and safety in the workplace.
The requirements of relevant local health and safety guidelines, manuals and
other documents, including the underpinning legislation.
The cause of errors related to patient safety, including patient and/or sample
identification.
• The importance of the correct use of clinical coding and medical terminology in
contributing to good healthcare science practice.
• Information governance principles and process.
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KEY
LEARNING
OUTCOMES
7
7
7
COMPETENCES
scope of practice.
Keep accurate records in
accordance with current
guidelines and the legal
framework for data security.
Use, in your practice:
• standard operating
procedures
• protocols
• clinical guidelines.
Continuously improve your
practice through good
practice in:
• identifying common
sources of error
• identification of risk
• reporting critical incidents.
KNOWLEDGE AND UNDERSTANDING
• Best practice recommendations for record keeping and data security.
• The Data Protection Act and current key guidelines, and the legal framework for
data security.
• Standard operating procedure, protocol and guideline, and understand the
purpose of and difference between each document.
• Evidence base that underpins the use of procedures employed by the service.
• The desirability of monitoring performance, internal and external quality control,
learning from mistakes and adopting a no-blame culture in order to ensure high
standards of care and optimise patient safety.
• The importance of honesty and effective apology in responding to errors of
practice.
• The principles and practice of risk management and the effective investigation of
incidents, resulting in the identification of root causes.
Research and Innovation
8,9
Participate in innovation,
research, service
development and audit
activities complying with
compliance with guidance
and laws relating to
research ethics.
•
•
•
•
•
•
•
The importance of innovation across healthcare science.
The role of innovation in improving quality and patient care.
Processes to disseminate innovation, research and audit findings.
The role of the healthcare scientist and the potential impact of scientific research
in your area of practice.
The role of the healthcare scientist in service developments in your area of
practice.
Current and developing clinical practice.
The effectiveness of investigations, therapies, interventions and treatments and
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KEY
LEARNING
OUTCOMES
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
•
the mechanisms by which they contribute to patient care.
How to horizon scan, identify and evaluate the potential role for new and
innovative technologies and scientific advances.
The role of the healthcare scientist and the potential impact of scientific
developments, for example health prevention, genomic medicine, diagnostics
and rehabilitation.
The importance of public engagement in science and its role in health and
society.
The legal framework relevant to informed consent and the application to clinical
care, research, audit and teaching.
How planning can actively contribute to the achievement of service goals.
How to measure and monitor performance against agreed targets.
The current structure, management, legal framework and quality improvement
structures and processes within the NHS.
The current quality improvement structures and processes within the NHS and
give examples of the implications for Healthcare Science.
Importance of self-care and shared care as part of NHS function and the impact
of life-threatening and critical conditions.
Principles and application of evidence-based practice.
•
•
•
•
How to critically analyse scientific literature.
How to structure and present a critical analysis.
Systems of referencing.
Reference manager software.
•
•
•
How to prepare an oral scientific communication.
How to give an effective and timely oral presentation.
How to respond to questioning.
•
•
•
•
8,9
Contribute to service and
quality improvement and
productivity in the work base
and embed evidence-based
developments within routine
practice.
•
•
•
•
•
8,9
8,9
Undertake a literature review
and prepare and present to
peers a critical analysis of a
publication from the scientific
literature.
Prepare and deliver an oral
scientific communication to
peers at a local, national or
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KEY
LEARNING
OUTCOMES
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
international meeting.
Clinical Leadership
10
10
Lead in your clinical role
through appropriate
application of;
• self-management
• self-development
• integrity
• self-direction
• problem solving
• dealing with complex
issues
• making sound judgements
in the absence of
complete data.
Identify potential areas for
change and accept change
identified by others, working
across different provider
landscapes as required.
• How self-awareness, self-management and self-development and acting with
integrity at all times contribute to leadership.
• The use of evidence, both positive and negative to identify options in addressing
challenges.
• Methods of prioritising and organising academic and work based tasks to
optimise own performance.
•
•
•
Structure of the NHS.
The need for change, working across different provider landscapes as required.
Change management methodologies.
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Cellular Sciences
SECTION 5: ELECTIVE LEARNING FRAMEWORK
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STP Learning Framework
This section describes the Learning Framework for the Elective component of Specialist work based
learning, covering the Learning Outcomes, Clinical Experiential Learning, Competence, and Applied
Knowledge and Understanding. This module spans the Rotational and Specialist period of training.
Each trainee is also expected to build on and apply the knowledge, skills and experience gained from
the MSc in Clinical Science
ELECTIVE
DIVISION
Life Sciences, Physiological Sciences, Physical Sciences and
Biomedical Engineering
THEME
ALL
SPECIALISM
ALL
The elective period can be taken any time during the specialist training. It may comprise a single 4- to 6-week elective or a series of
shorter periods of elective training.
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MODULE
TITLE
AIM
SCOPE
Elective (EL)
COMPONENT
Specialist
The aim of the elective period is to facilitate wider experience of healthcare and/or the practice of Healthcare
Science in a cultural and/or clinical setting that is different from the usual training environment. This may
involve healthcare or Healthcare Science in a different area of the health service, or in pursuit of a particular
clinical or research interest.
The elective provides opportunities for you to:
• explore in depth areas of particular interest beyond the scope of the scientist training programme
• increase awareness of important health issues and develop an understanding of the effect of disease on
communities and individuals in different cultural contexts
• explore unfamiliar scientific, social, economic or cultural areas
• become more proficient at communication with individuals from different social, cultural and ethnic
backgrounds
• gain hands-on experience that might not otherwise be possible in a scientist training programme
• design and undertake a significant assignment with appropriate guidance and supervision, thereby
developing personal and organisational skills
• undertake a small audit or research project in a different clinical setting
• relate your experiences to your own area of practice.
LEARNING OUTCOMES
Learning outcomes are specific to each student: with guidance, you are expected to identify your own educational objectives and
organise an elective to achieve them.
1. Agree, organise and complete a period of education and training that provides a wider experience of healthcare and/or the
practice of healthcare science, and aligns with Good Scientific Practice.
2. Critically reflect on your experience in your elective and develop an action plan as part of your continuing personal and
professional development.
3. Prepare a presentation and present your elective experiences to colleagues, including trainee healthcare scientists.
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KEY
LEARNING
OUTCOMES
1
2
3
COMPETENCES
Produce learning outcomes for the
elective training period and link
these to Good Scientific Practice.
Write a report of your elective
training that includes your learning
outcomes (mapped to Good
Scientific Practice), a critical
reflection on your experience and
an action plan.
Plan, prepare and deliver an oral
presentation that describes and
reflects on the learning from your
elective and shows how your
experience will shape your future
practice.
KNOWLEDGE AND UNDERSTANDING
•
Good Scientific Practice.
•
•
•
Report writing.
Critical reflection.
Action planning.
•
•
•
•
How to prepare an oral communication.
How to give an effective and timely oral presentation.
Use of visual aids.
How to respond to questioning.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
Cellular Sciences
SECTION 6: SPECIALIST LEARNING FRAMEWORK
CYTOPATHOLOGY
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
STP Learning Framework
This section describes the Learning Framework for the Specialist Component of work based learning
covering the Learning Outcomes, Clinical Experiential Learning, Competence and Applied Knowledge
and Understanding. Each trainee is also expected to build on and apply the knowledge, skills and
experience gained from the MSc in Clinical Science.
Specialist Modules
DIVISION
Life Sciences
THEME
Cellular Sciences
SPECIALISM
Cytopathology
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CYTOPATHOLOGY – SPECIALIST MODULES
Module 1 (CP-2)
Pathological Basis of Disease
Module 2 (CP-3)
Systematic Investigation of Pathological Specimens
Module 3 (CP-4)
Major Organ Histopathology including Cancer
Module 4 (CP-5)
Gynaecological Cytopathology
Module 5 (CP-6)
Non-Gynaecological Cytopathology
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MODULE 1
AIM
SCOPE
Pathological Basis of Disease (CP-2)
COMPONENT Specialist
This module will provide trainees with the overall knowledge and understanding of the pathological
basis of disease and the principles and practice of histopathology as applied to clinical medicine.
The trainee will use a range of histological techniques and learn to recognise different types of
pathology under the microscope in order to gain experience of interpreting results from patient
investigations.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
1.
2.
3.
4.
5.
6.
7.
Recognise and interpret the microscopical appearance of the tissue or cell and relate to the pathobiological process.
Determine adequacy of samples taken by clinicians.
Determine adequacy of margins of exision or clearance where applicable.
Advise on or request appropriate additional tests to aid in the diagnosis of disease.
Recognise carcinoma and local and metastatic tumour spread in microscopic specimens.
Under supervision, prepare preliminary reports based on using interpretive and diagnostic skills.
Work in partnership with other clinical specialisms as part of the diagnosis and review of individual cases.
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CLINICAL EXPERIENTIAL LEARNING
The clinical experiential learning for this module is:
•
•
•
•
Review prepared microscope slides with your supervisor and draft a diagnosis, taking into account all relevant clinical details,
and the macroscopical and microscopical appearances of the tissues.
Double-headed microscopical slide review – working directly with a pathologist perform light microscopy studies on specimens
from a range of clinical referrals. In each case identify key histological or cytological features and agree how these may be
incorporated into a report prepared in the correct clinical context
Attend multidisciplinary team meetings – participate in multidisciplinary review meetings at which histopathology results are
presented as part of the clinical record. Prepare a portfolio of cases to illustrate how key histological and cytological findings
influenced diagnosis and patient management
Prepare a portfolio of cases from named clinical conditions where you have played a significant role in the systematic
investigation
LABORATORY EXPERIENTIAL LEARNING
•
Become familiar with the laboratory quality management system and perform examination and other audits as part of the
laboratory accreditation process (applies to all specialist modules).
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional practice
competences alongside the competences defined in this module.
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KEY
LEARNING
OUTCOMES
1,4
1,4
1,4
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
Using representative specimens
from a range of tissues, identify the
different types of inflammatory
disease:
• acute inflammation
• chronic inflammation
• granulomatous inflammation.
•
•
•
Using representative specimens
from a range of tissues, identify cell
proliferation, growth and death:
• hypoplasia
• hyperplasia
• metaplasia
• benign neoplasia
• premalignancy
• neoplastic proliferation
• cell injury and adaptation
• apoptosis
• necrosis
• degenerative disease.
Identify the mechanisms of
transmission and clinical
manifestations of both acute and
chronic infections in tissue sections:
• bacteria
• viruses
•
•
•
•
•
•
•
•
•
•
•
Normal morphology of tissues and organs.
Epidemiology of common pathologies.
The mechanisms involved in the inflammatory process, including the
cell types involved and the cascade of inflammatory response.
The differences between all three types of inflammation and their role
in disease, repair and healing.
Rationale of the histological techniques required to demonstrate the
different cell types involved in a tissue section.
Normal morphology of tissues and organs.
Epidemiology of common pathologies.
The microscopical differences between normal tissue morphology
and proliferative tissue morphology.
The microscopical differences between normal tissue morphology
and tissue undergoing necrosis.
Principles of good fixation and paraffin processing.
Rationale of the different histological techniques required to
demonstrate the different cell types involved in a tissue section.
Principles of infectious diseases and the immune response to
infection.
General principles of infection control in the management of the
patient.
Rationale of the histological techniques required to demonstrate a
wide range of infectious agents in a tissue section.
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KEY
LEARNING
OUTCOMES
1,4
1,4
2,3,5
COMPETENCES
• fungi
• parasites.
Using representative specimens
from a range of tissues, identify the
immune response and
immunological disease in:
• normal immune system
• primary and secondary
immunodeficiency
• autoimmune disease
• transplant rejection.
Using representative specimens
from a range of tissues, identify cell
injury, wound healing and repair in:
• tissue and cell injury
• hypertrophy
• thrombosis
• atherosclerosis
• embolism
• oedema.
Using representative specimens
from a range of tissues, identify
carcinoma and local and metastatic
tumour spread, including:
• premalignancy change
• benign neoplastic change
• malignant neoplastic change
• angiogenesis
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
•
•
•
•
The normal immune response mechanism and how this can be
triggered following organ transplantation.
The use of immunological techniques, and how the immune
response and immunological disease may be identified in
microscopic specimens.
Normal morphology of tissues and organs.
The identification of a range of cell injuries, wound healing and tissue
repair in microscopic specimens.
Rationale of the histological techniques required to demonstrate the
different cell types involved in a tissue section.
Normal morphology of tissues and organs.
The identification of carcinoma and local and metastatic tumour
spread, at a macroscopic, microscopic and molecular level.
Rationale of the histological techniques required to demonstrate the
different cell types involved in a tissue section.
Methods for marking excision margins.
Methods for measuring distance of tumour spread from margins of
excision.
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KEY
LEARNING
OUTCOMES
6,7
COMPETENCES
• metastasis.
Interpret the histological or
cytological findings in the correct
clinical context and discuss in detail
with a senior colleague.
KNOWLEDGE AND UNDERSTANDING
•
•
•
The use of the light microscope.
The relationship between clinical presentation and the diagnosis.
The relative merits of cytology, histology and pathology results when
making an informed and accurate diagnosis.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
MODULE 2
AIM
SCOPE
Systematic Investigation of Pathological
Specimens (CP-3)
COMPONENT Specialist
This module will provide trainees with the knowledge and understanding of the pathological basis of
disease and the use of histopathology to detect and diagnose disease.
The trainees will become competent in the application of a range of techniques to case studies in
clinical practice and gain experience of interpreting results from patient investigations.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
1.
2.
3.
4.
5.
Participate in the collection of a range of histopathology and cytopathology clinical specimens.
Perform investigations for the diagnosis, treatment and monitoring of named clinical conditions.
Evaluate and communicate the limitations of a range of investigative techniques in named clinical conditions.
Determine and give clinical advice on the sensitivity and specificity of investigative techniques in named clinical conditions.
Under supervision, prepare and interpret reports that involve a range of histological and cytological techniques as part of the
systematic investigation of named clinical conditions.
6. Work in partnership with other clinical specialisms as part of the diagnosis and review of individual cases.
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CLINICAL EXPERIENTIAL LEARNING
The clinical experiential learning for this module is:
• Prepare an evidence-based report listing the strengths and limitations of a range of investigative techniques used in named
•
•
•
•
•
clinical conditions.
Describe and apply evidence-based data on the sensitivity of investigative techniques in named clinical conditions. To include
suggesting clinical advice in specific clinical cases.
Working directly with a pathologist, discuss the systematic investigation that you have performed in named clinical conditions on
specimens from a range of clinical referrals. In each case, agree how these may be incorporated into a report prepared in the
correct clinical context.
Participate in multidisciplinary review meetings at which histopathology results are presented as part of the clinical record.
Prepare a portfolio of cases to illustrate how key histological and cytological findings may be integrated with imaging and other
diagnostic findings to facilitate diagnosis and patient management in named clinical conditions.
Attend clinics and ward rounds where patients with named clinical conditions are investigated. Gain understanding of the
importance of pathology to the patient journey and write a reflective account of what you have learned.
Prepare a portfolio of cases from named clinical conditions where you have played a significant role in the systematic
investigation and include the use and interpretation of sensitivity and specificity data.
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional practice
competences alongside the competences defined in this module.
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KEY
LEARNING
OUTCOMES
1
2
4
3
COMPETENCES
Use a range of methods for the
identification and collection of tissue
and cellular preparations for the
microscopic investigation of named
common conditions, to include:
• needle biopsy
• surgical biopsy.
Interpret clinical requests and
associated specimens to prioritise
investigations, including the
identification of urgent cases.
Interpret clinical requests and
associated specimens from named
clinical conditions and plan the
investigations to be performed in
line with agreed protocol.
Prepare and perform macroscopic
examination and dissection of
specimens as part of systematic
investigation of named clinical
conditions, to include:
• macroscopic examination of
organs and tissues
• orientation and marking
• dissection and sampling of
Category A to C specimens
according to local protocol
• macrophotography during
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
•
•
•
•
Dissection and sample preparation protocols for a wide range of
invasive and non-invasive sample types and identification of the
factors that influence the choice of invasive or non-invasive
technique, e.g. smears, aspirates, biopsies, excisions, resections.
Use of ultrasound to accurately identify biopsy site.
Clinical terminology for a variety of clinical conditions.
The relative seriousness of different clinical conditions and the need
for rapid results, e.g. cancer pathway, frozen sections while the
patient is in theatre, etc.
RCPath minimum data sets.
Awareness of the relationship between imaging and the histological
and cytological sample, e.g. ultrasound to identify the specific sample
site, and appreciate possible pitfalls.
Anatomy and physiology of normal tissues and organs.
Use of an example systemic pathway, e.g. urology, and follow
agreed protocols for dissection and sample preparation to obtain the
best result for the patient.
Limits of own practice and when to seek clinical advice.
RCPath minimum data sets.
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KEY
LEARNING
OUTCOMES
6
5,6
COMPETENCES
dissection
• note taking during dissection
• specialised containment to
prevent sample loss or crosscontamination
• containment of high-risk samples
• recognition of own limits of
practice.
Prepare and section tissue blocks
and perform routine and specialised
procedures in line with systematic
investigation of named clinical
conditions, to include:
• routine and special stains
• decalcification of tissues
• immunocytochemistry
• in situ hybridisation
• molecular pathology.
Interpret routine and specialised
investigations performed and
recommend appropriate action, to
include:
• identification microscopically of
normal and abnormal tissue
• request specialised
demonstration techniques
• reporting.
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
•
•
•
Rationale and protocols for a range of histological techniques.
Application of a range of sampling and staining techniques and using
them in a systematic way, relating them to the clinical presentation
and following agreed protocols, to ensure quality control is
maintained.
Quality assurance relating to techniques used.
Imaging techniques applied to tissue sections.
Microscopic appearance of normal and abnormal cells.
Appreciation of the importance of a timely and accurate
histopathology and cytopathology diagnosis in the clinical
management of the patient.
Appreciation of how the formatting of a report assists the clinician in
understanding the findings.
Appreciation of the contribution of the results of other clinical
investigations and other pathology results.
Current legislation relating to the retention of cells, tissues and
organs.
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MODULE 3
AIM
SCOPE
Major Organ Histopathology including
Cancer (CP-4)
COMPONENT Specialist
This module will provide trainees with the knowledge and understanding of the cellular structure and
function of the major organs, and the cellular pathological findings in a range of clinical disorders,
including commonly occurring forms of cancer.
The trainee will become competent in the application of a range of techniques to these clinical disorders
and gain experience of interpreting results from patient investigations.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
1. Identify and confirm the clinical presentation of a range of major organ diseases and commonly occurring forms of cancer.
2. Perform to quality standards a range of established cellular pathology techniques to named disorders of the major organs and
commonly occurring forms of cancer.
3. Identify and evaluate new equipment, methods or procedures to enhance the contribution of the cellular pathology laboratory to
the diagnosis and management of major organ disease and commonly occurring forms of cancer.
4. Under supervision, prepare and interpret reports that involve cellular pathology findings as part of the investigation of major
organ disease.
5. Work in partnership with other clinical specialisms as part of the diagnosis and review of named clinical diseases of major
organs and commonly occurring forms of cancer.
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CLINICAL EXPERIENTIAL LEARNING
The clinical experiential learning for this module is:
• Prepare an example cellular pathology report for a resection specimen and demonstrate the ability to discuss the essential
elements included.
• Produce a portfolio demonstrating knowledge and understanding of dissection practice and how it relates to the diagnostic
•
•
•
•
process and subsequent patient care. Include details of investigations undertaken, with explanations, in the portfolio of cases
prepared for learning outcome 1.
Attend wards and clinics at which patients with named major organ diseases and commonly occurring cancers are being
investigated and write a reflective account of what you have learned.
Attend multidisciplinary meetings where patients with a major organ system disorder and a commonly occurring cancer are being
discussed and write a reflective account of the experience.
Visit a laboratory involved in supporting organ transplantation and describe the interaction with the clinical transplant team. Write
a reflective account of your visit.
Prepare a portfolio of illustrative cases with a minimum of three from the listed major organ pathologies and three from the listed
commonly occurring cancers. Include the plan of laboratory investigation. To be developed further in learning outcomes 2 and 5.
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional practice
competences alongside the competences defined in this module.
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KEY
LEARNING
OUTCOMES
1
2
COMPETENCES
From routine requests, identify the
cellular pathology specimens
required to confirm a diagnosis in
each of the following major organ
systems and perform the relevant
techniques to process the sample:
• dermatopathology
• breast pathology
• hepatobiliary pathology
• gastrointestinal pathology
• genitourinary pathology
• respiratory pathology
• gynaecological pathology
• male reproductive pathology
• endocrine pathology
• ear, nose and throat pathology
• osteoarticular pathology.
Perform and record details of
macroscopic examination of tissue
received from named major organ
disease and commonly occurring
cancers, to include:
• dermatopathology
• breast pathology
• hepatobiliary pathology
• gastrointestinal pathology
• genitourinary pathology
• respiratory pathology
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
•
The aetiology and clinical presentation of a selection of common
tissue samples in named major organ disease (excluding cancer).
Impact on the patient pathway of the accuracy and timeliness of the
histological diagnostic process.
Anatomy and physiology of normal tissues and organs.
Appropriate methods of sample preparation and processing
protocols.
Impact on the patient pathway of the accuracy of the description of
samples and its importance in the timeliness of the histological
diagnostic process.
Macroscopic appearance of a range of cellular pathology specimens
relating to common diseases, including cancer, in different organ
systems (non-cancer).
Specific dissection criteria applicable to specific disease conditions.
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KEY
LEARNING
OUTCOMES
2
3
1,2,3
COMPETENCES
• gynaecological pathology
• male reproductive pathology
• endocrine pathology
• ear, nose and throat pathology
• osteoarticular pathology.
Perform to quality standards, basic
and appropriate specialised cellular
pathology techniques as part of the
systematic investigation of tissue
received from named major organ
diseases and commonly occurring
cancers, to include:
• dermatopathology
• breast pathology
• hepatobiliary pathology
• gastrointestinal pathology
• genitourinary pathology
• respiratory pathology
• gynaecological pathology
• male reproductive pathology
• endocrine pathology
• ear, nose and throat pathology
• osteoarticular pathology.
Perform a detailed evaluation of one
new piece of equipment, method or
procedure.
Perform to quality standards,
cellular pathology tests of rejection
KNOWLEDGE AND UNDERSTANDING
•
The requirements of quality-based diagnostic procedures in ensuring
safe and effective care of the patient.
Rationale of the cellular pathology techniques required to
demonstrate the different cell types involved in tissue sections from
major organs and from commonly occurring cancers.
•
•
•
•
The impact of effective methodological assessment.
Use of controls.
Report writing.
Ethical and legal issues around transplantation and the role of
immunosuppression.
•
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KEY
LEARNING
OUTCOMES
COMPETENCES
from tissue grafts and/or organ
transplantation.
KNOWLEDGE AND UNDERSTANDING
•
•
4
In discussion with a pathologist,
interpret in the correct clinical
context the results of:
• macroscopic examination
• basic microscopic examination
• appropriate specialised
techniques
• diagnostic algorithms
from specimens received from a
range of named major organ
diseases and commonly occurring
cancers, to include:
• dermatopathology
• breast pathology
• hepatobiliary pathology
• gastrointestinal pathology
• genitourinary pathology
• cardiac and vascular pathology
• respiratory pathology
• gynaecological pathology
• male reproductive pathology
• endocrine pathology
•
•
•
•
•
The role of the clinical laboratory in major organ transplantation,
including ethical and legal issues and the role of
immunosuppression.
Multi-organ transplantation and the microscopic appearance of
rejection.
Morphological presentation of a range of major organ systems.
Microscopic appearance of normal and abnormal cells.
Application of a wide range of cellular pathology techniques.
The importance of a timely and accurate histopathology and
cytopathology diagnosis in the clinical management of the patient.
How the formatting of a report assists the clinician in understanding
the findings.
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KEY
LEARNING
OUTCOMES
4,5
COMPETENCES
• ear, nose and throat pathology
• osteoarticular pathology.
In discussion with a pathologist,
prepare and issue reports from the
selected cases of named major
organ disease and commonly
occurring cancer in the context of
other clinical information.
KNOWLEDGE AND UNDERSTANDING
•
•
•
Impact on the patient pathway of the detail and accuracy of the
description within the diagnosis, and its importance in the timeliness
of the treatment and management pathway of the patient.
How the formatting of a report assists the clinician in understanding
the findings.
The contribution of the results of other clinical investigations and
other pathology results.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
MODULE 4
AIM
SCOPE
Gynaecological Cytopathology (CP-5)
COMPONENT Specialist
This module will provide the trainee with the knowledge and understanding of the aetiology,
pathogenesis and main clinical and morphological features of cervical and other gynaecological cancers.
They will understand and gain experience of the role of the cytology laboratory in the diagnosis of
cervical pre-cancer and gynaecological malignancy.
The trainee will become skilled in the use of the microscope in the initial diagnosis of a range of
gynaecological disorders. They will gain experience of interpreting results from patient investigations.
The trainee will be able to describe national and international screening programmes and achievements
in the prevention, diagnosis and management of cervical cancer.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
1.
2.
3.
4.
5.
Recognise and interpret the microscopical appearance of cells and relate to the pathobiological process.
Recognise the clinical presentation of a range of gynaecological malignancies.
Screen and interpret cervical cytology samples to quality standards.
Advise on or request appropriate additional tests to aid in the diagnosis of disease.
Identify and evaluate new equipment, methods or procedures to enhance the contribution of the cytopathology laboratory to the
prevention, diagnosis and management of gynaecological malignancies.
6. Analyse national and international data on the incidence, screening, diagnosis, management and survival of gynaecological
malignancies.
7. Draft interpretative reports that involve cytopathological findings as part of the investigation of gynaecological malignancies.
8. Work in partnership with other clinical specialisms as part of the diagnosis and review of gynaecological malignancies.
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CLINICAL EXPERIENTIAL LEARNING
The clinical experiential learning for this module is:
• Attend and participate in multidisciplinary review meetings at which cytopathology results from cases of gynaecological cancer
•
•
•
•
•
•
•
•
are presented as part of the clinical record. Wherever possible include those cases in your portfolio of named cancers. Record
the outcomes of the multidisciplinary review meetings.
Include details of investigations undertaken, including molecular techniques, with explanations, in the portfolio of cases prepared
for learning outcome 2.
Review prepared microscope slides on a double-headed microscope with a supervisor and draft a diagnosis taking into account
all relevant clinical details.
Perform an audit on a specific topic analysing the morphological findings and clinical outcomes.
Perform a detailed evaluation of one new piece of equipment, method or procedure. Critically appraise the results of the
evaluation and produce a report with recommendations.
Describe the operation of the NHS Cervical Screening Programme and indicate your role in the programme.
Write a cytopathology report on a range of gynaecological cancers, appreciating the partnership between the cytopathology
laboratory and other clinical specialisms.
Suggest ways in which improved diagnostics could lead to better clinical outcomes in gynaecological malignancy.
Prepare a portfolio of a minimum of 10 illustrative cases of gynaecological malignancies where you have played a significant role
in the investigation. Include the plan of laboratory investigation.
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional practice
competences alongside the competences defined in this module.
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KEY
LEARNING
OUTCOMES
1
1,2,4
2
COMPETENCES
Analyse cervical samples to identify
normal morphology, inflammation
and dyskaryosis.
Prepare a diagnostic pathway, from
diagnosis to treatment for
gynaecological cancers, to include:
• cervical pathology
•
cervical intraepithelial
neoplasia (CIN)
•
cervical glandular
intraepithelial neoplasia
(CGIN)
•
cervical cancer
• ovarian cancer
• endometrial cancer
• extrauterine malignancies.
Perform the reception and
preparation cytopathological
specimens for the investigation of
cervical pre-cancer.
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
Normal morphology.
Inflammatory changes in epithelial cells.
Inflammatory agents.
Low-grade dyskaryosis.
High-grade dyskaryosis in squamous and endocervical cells.
Invasive squamous cell carcinoma.
Endocervical adenocarcinoma.
Malignancy from non-cervical origin.
Pitfalls in diagnosis.
External quality assessment in cervical cytology.
Aetiology.
Screening history.
Clinical symptoms.
Cytomorphology.
Molecular and ancillary tests (including human papilloma virus [HPV]
primary screening).
Histopathology.
Role of the multidisciplinary team.
Treatment.
Prognosis.
•
•
•
•
•
Technologies used to prepare cervical cytology samples.
The limitations of liquid-based cytology (LBC) technologies.
Troubleshooting of instrument failure.
Novel approaches to LBC preparation.
Routine staining methods.
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
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KEY
LEARNING
OUTCOMES
COMPETENCES
3,4
Perform to quality standards, basic
and appropriate specialised
cytopathological techniques as part
of the systematic investigation of
gynaecological malignancy.
5
Use and evaluate new equipment
relevant to the cytological
investigation of gynaecological
cancer.
Present the evidence base for the
effectiveness and limitations of the
NHS Cervical Screening
Programme.
6
7
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
In discussion with a histopathologist, •
interpret in the correct clinical
•
context the histopathology of:
•
• cervical intraepithelial neoplasia
•
(CIN)
•
HPV test of cure and triage.
Cytocentrifugation.
Cell blocks.
Impact of preparation techniques on subsequent ancillary testing.
Molecular techniques, including quality control.
Imaging-assisted screening.
Internal quality control methods in cervical cytology.
Methodology for assessing new pieces of equipment and introducing
new techniques in comparison with existing methodologies.
ABC3 standards.
NHS Cervical Screening Programme publications.
Cancer registry.
Management of the screening programme.
Call recall.
Invasive audit.
HPV vaccination.
Role of colposcopy.
HPV testing.
Screening intervals.
Age range for screening.
HPV primary screening pathways in other countries.
Recognition of normal pathology.
Identification of benign processes.
Recognition of CIN and CGIN.
Identification of malignancy.
Rationale of additional histological techniques.
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KEY
LEARNING
OUTCOMES
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
cervical glandular intraepithelial
•
neoplasia (CGIN)
• cervical cancer
• ovarian cancer
• endometrial cancer
• extrauterine malignancies.
In discussion with a histopathologist, •
prepare and issue reports from the
selected cases of gynaecological
malignancy.
•
•
7,8
•
Treatment of CIN, CGIN and cervical cancer.
Impact on the patient pathway of the detail and accuracy of the
description within the diagnosis, and its importance in the timeliness
of the treatment and management pathway of the patient.
How the formatting of a report assists the clinician in understanding
the findings.
The contribution of the results of other clinical investigations and
other pathology results.
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MODULE 5
Non-Gynaecological Cytopathology (CP- COMPONENT Specialist
6)
AIM
This module will provide the trainee with the knowledge and understanding of the aetiology,
pathogenesis and main clinical features of cancers and benign conditions detected by nongynaecological cytopathology. They will understand and gain experience of the role of the cytology
laboratory in the diagnosis of selected cancers detected by non-gynaecological cytopathology.
The trainee will become skilled in the use of cellular pathology techniques in the initial diagnosis and
follow-up of a range of cancers and benign conditions. They will gain experience of interpreting results
from patient investigations.
SCOPE
LEARNING OUTCOMES
On successful completion of this module the trainee will:
1. Recognise and interpret the microscopical appearance of cells and relate to the pathobiological process.
2. Recognise the clinical presentation of cancers detected by non-gynaecological cytopathology.
3. Perform to internal quality standards a range of established cytopathological techniques used in non-gynaecological
cytopathology. Advise on or request appropriate additional tests to aid in the diagnosis of disease.
4. Identify and evaluate new equipment, methods or procedures to enhance the contribution of the cytopathology laboratory to the
diagnosis and management of non-gynaecological malignancies.
5. Draft interpretative reports that involve cytopathological findings as part of the investigation of non-gynaecological malignancies.
6. Work in partnership with other clinical specialisms as part of the diagnosis and review of non-gynaecological malignancies.
7. Analyse national and international data on the incidence, diagnosis, management and survival of malignancies detected by nongynaecological cytopathology.
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CLINICAL EXPERIENTIAL LEARNING
The clinical experiential learning for this module is:
•
•
•
•
•
•
•
•
•
Attend, and where appropriate assist in, the collection of specimens for cytopathological investigation. To include:
•
exfoliative techniques
•
brush techniques
•
aspiration techniques.
Attend and participate in multidisciplinary review meetings at which cytopathology results are presented as part of the clinical
record. Wherever possible include those cases included in your portfolio of named cancers. Record the outcomes of the
multidisciplinary review meetings.
Include details of investigations undertaken, including histochemical and molecular techniques, with explanations, in the
portfolio of cases prepared for learning outcome 1.
Perform a detailed evaluation of one new piece of equipment, method or procedure. Critically appraise the results of the
evaluation and produce a report with recommendations.
Write a cytopathology report of a range of non-gynaecological cancers, appreciating the partnership between the cytopathology
laboratory and other clinical specialisms.
Suggest ways in which improved diagnostics could lead to better clinical outcomes in non-gynaecological malignancy.
Prepare a portfolio of a minimum of 10 illustrative cases of non-gynaecological malignancies. Include the plan of laboratory
investigation.
Review prepared microscope slides on a double-headed microscope with a supervisor and draft a diagnosis taking into account
all relevant clinical details.
Perform an audit on a specific topic analysing the morphological findings and clinical outcomes.
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional practice
competences alongside the competences defined in this module.
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KEY
LEARNING
OUTCOMES
1
1
2
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
Analyse non-gynaecological
samples to identify normal
morphology, inflammation, benign
neoplasia and malignancy.
•
Interpret adequacy of samples at
on-site clinical procedures,
including:
• endobronchial ultrasound
(EBUS)
• endoscopic ultrasound (EUS)
• bronchoscopy
• endoscopic retrograde
cholangio-pancreatography
(ERCP)
• fine-needle aspiration (FNA) of
palpable and non-palpable
lesions.
Prepare a diagnostic pathway, from
diagnosis to treatment for nongynaecological cancers, to include:
• respiratory tract
• urinary tract
•
•
The cytological features of malignancies and benign conditions
commonly identified by non-gynaecological samples in the following
organ systems:
•
respiratory tract
•
urinary tract
•
gastrointestinal tract
•
serous cavities
•
thyroid gland
•
salivary glands
•
lymph nodes.
Assessment criteria for sample adequacy using the light microscope.
Communication of findings with clinical staff.
•
•
•
•
•
Aetiology.
Clinical symptoms.
Diagnostic modalities.
Cytomorphology.
Molecular and ancillary tests.
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KEY
LEARNING
OUTCOMES
2
3
3
COMPETENCES
• gastrointestinal tract
• serous cavities
• thyroid gland
• salivary glands
• lymph nodes.
Perform the reception and basic
preparation of specimens for the
investigation of non- gynaecological
cancer.
Perform to quality standards
appropriate specialised
cytopathological techniques as part
of the systematic investigation of
non-gynaecological cancer.
Perform to quality standards at least
three of the following specialised
techniques, including:
• immunocytochemistry
• immunofluorescence
• fluorescence in-situ hybridisation
• molecular techniques
• interrogation of molecular
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
Histopathology.
Role of multidisciplinary team.
Treatment.
Prognosis.
•
•
•
•
•
•
•
•
•
•
•
Technologies used to prepare non-gynaecological cytology samples.
The limitations of preparation techniques.
Novel approaches to non-gynaecology specimen preparation.
Impact of preparation techniques on subsequent ancillary testing.
Direct wet-fixed and air-dried preparations.
Wet preparation techniques.
Routine Papanicolaou and Romanowsky stains.
Cytocentrifugation.
Cell blocks.
Internal quality control in preparation of non-gynaecology specimens.
Histochemical and molecular techniques.
•
•
Theoretical knowledge of principles of specialised techniques.
Appropriate application of these techniques to the condition under
investigation.
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KEY
LEARNING
OUTCOMES
4
5
5,6,7
COMPETENCES
databases
• electron microscopy
• flow cytometry
• image analysis.
Use and evaluate new equipment
relevant to the cytological
investigation of non-gynaecological
cancer.
In discussion with a supervisor,
interpret in the correct clinical
context the results of cytological
investigations in non-gynaecological
cancer, to include:
• respiratory tract
• urinary tract
• gastrointestinal tract
• serous cavities
• thyroid gland
• salivary glands
• lymph nodes.
In discussion with a pathologist,
prepare and issue reports from the
selected cases of nongynaecological cancer.
KNOWLEDGE AND UNDERSTANDING
•
Methodology for assessing new pieces of equipment and introducing
new techniques in comparison with existing methodologies.
•
•
•
Features of normal, benign and malignant pitfalls in diagnosis.
Knowledge of available ancillary tests and their appropriate use.
Significance of clinical histories.
•
Impact on the patient pathway of the detail and accuracy of the
description within the diagnosis, and its importance in the timeliness
of the treatment and management pathway of the patient.
How the formatting of a report assists the clinician in understanding
the findings.
The contribution of the results of other clinical investigations and
other pathology results.
•
•
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
Cellular Sciences
SECTION 7: SPECIALIST LEARNING FRAMEWORK
HISTOPATHOLOGY
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STP Learning Framework
This section describes the Learning Framework for the Specialist Component of work based
learning covering the Learning Outcomes, Clinical Experiential Learning, Competence and Applied
Knowledge and Understanding. Each trainee is also expected to build on and apply the
knowledge, skills and experience gained from the MSc in Clinical Science.
Specialist Modules
DIVISION
Life Sciences
THEME
Cellular Sciences
SPECIALISM
Histopathology
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
HISTOPATHOLOGY – SPECIALIST MODULES
Module 1 (HP-2)
Pathological Basis of Disease
Module 2 (HP-3)
Systematic Investigation of Pathological Specimens
Module 3 (HP-4)
Major Organ Histopathology excluding Cancer
Module 4 (HP-5)
Cancer
Module 5 (HP-6)
Specialised Histopathology
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MODULE 1
AIM
SCOPE
Pathological Basis of Disease (HP-2)
COMPONENT Specialist
This module will provide trainees with the overall knowledge and understanding of the pathological
basis of disease and the principles and practice of Histopathology as applied to clinical medicine.
The trainee will use a range of histological techniques and learn to recognise different types of
pathology under the microscope in order to gain experience of interpreting results from patient
investigations.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
8. Recognise and interpret the microscopical appearance of the tissue or cell and relate to the pathobiological process.
9. Determine adequacy of samples taken by clinicians.
10. Determine adequacy of margins of excision or clearance, where applicable.
11. Advise on or request appropriate additional tests to aid in the diagnosis of disease.
12. Recognise carcinoma and local and metastatic tumour spread in microscopic specimens.
13. Under supervision, prepare preliminary reports based on using interpretive and diagnostic skills.
14. Work in partnership with other clinical specialisms as part of the diagnosis and review of individual cases.
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CLINICAL EXPERIENTIAL LEARNING
The clinical experiential learning for this module is:
• Review prepared microscope slides with your supervisor and draft a diagnosis taking into account all relevant clinical details, the
macroscopical and microscopical appearances of the tissues.
• Double-headed microscopical slide review. Working directly with a pathologist, perform light microscopy studies on specimens
from a range of clinical referrals. In each case identify key histological or cytological features and agree how these may be
incorporated into a report prepared in the correct clinical context.
• Attend multidisciplinary team meetings. Participate in multidisciplinary review meetings at which histopathology results are
presented as part of the clinical record. Prepare a portfolio of cases to illustrate how key histological and cytological findings
influenced diagnosis and patient management.
• Prepare a portfolio of cases from named clinical conditions where you have played a significant role in the systematic
investigation.
LABORATORY EXPERIENTIAL LEARNING
• Become familiar with the laboratory quality management system and perform examination and other audits as part of the
laboratory accreditation process (applies to all specialist modules).
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional practice
competences alongside the competences defined in this module.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
KEY
LEARNING
OUTCOMES
1, 4
1, 4
1,4
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
Using representative specimens
from a range of tissues, identify the
different types of inflammatory
disease:
• acute inflammation
• chronic inflammation
• granulomatous inflammation.
•
•
•
Using representative specimens
from a range of tissues, identify cell
proliferation, growth and death:
• hypoplasia
• hyperplasia
• metaplasia
• benign neoplasia
• premalignancy
• neoplastic proliferation
• cell injury and adaptation
• apoptosis
• necrosis
• degenerative disease.
Identify the mechanisms of
transmission and clinical
manifestations of both acute and
chronic infections in tissue sections:
• bacteria
• viruses
• fungi
•
•
•
•
•
•
•
•
•
•
•
Normal morphology of tissues and organs.
Epidemiology of common pathologies.
The mechanisms involved in the inflammatory process, including the
cell types involved and the cascade of inflammatory response.
The differences between all three types of inflammation and their role
in disease, repair and healing.
Rationale of the histological techniques required to demonstrate the
different cell types involved in a tissue section.
Normal morphology of tissues and organs.
Epidemiology of common pathologies.
The microscopical differences between normal tissue morphology
and proliferative tissue morphology.
The microscopical differences between normal tissue morphology
and tissue undergoing necrosis.
Principles of good fixation and paraffin processing.
Rationale of the different histological techniques required to
demonstrate the different cell types involved in a tissue section.
Principles of infectious diseases and the immune response to
infection.
General principles of infection control in the management of the
patient.
Rationale of the histological techniques required to demonstrate a
wide range of infectious agents in a tissue section.
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KEY
LEARNING
OUTCOMES
1,4
1,4
2,3,5
COMPETENCES
• parasites.
Using representative specimens
from a range of tissues to identify
the immune response and
immunological disease in:
• normal immune system
• primary and secondary
immunodeficiency
• autoimmune disease
• transplant rejection.
Using representative specimens
from a range of tissues identify cell
injury, wound healing and repair in:
• tissue and cell injury
• hypertrophy
• thrombosis
• atherosclerosis
• embolism
• oedema.
Using representative specimens
from a range of tissues identify
carcinoma and local and metastatic
tumour spread including:
• premalignancy change
• benign neoplastic change
• malignant neoplastic change
• angiogenesis
• metastasis.
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
•
•
•
•
The normal immune response mechanism and how this can be
triggered following organ transplantation.
The use of immunological techniques, and how the immune
response and immunological disease may be identified in
microscopic specimens.
Normal morphology of tissues and organs.
The identification of a range of cell injuries, wound healing and tissue
repair in microscopic specimens.
Rationale of the histological techniques required to demonstrate the
different cell types involved in a tissue section.
Normal morphology of tissues and organs.
The identification of carcinoma and local and metastatic tumour
spread, at a macroscopic, microscopic and molecular level.
Rationale of the histological techniques required to demonstrate the
different cell types involved in a tissue section.
Methods for marking excision margins.
Methods for measuring distance of tumour spread from margins of
excision.
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KEY
LEARNING
OUTCOMES
6,7
COMPETENCES
Interpret the histological or
cytological findings in the correct
clinical context and discuss in detail
with a senior colleague.
KNOWLEDGE AND UNDERSTANDING
•
•
•
The use of the light microscope.
The relationship between clinical presentation and the diagnosis.
The relative merits of cytology, histology and pathology results when
making an informed and accurate diagnosis.
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MODULE 2
AIM
SCOPE
Systematic Investigation of Pathological
Specimens (HP-3)
COMPONENT Specialist
This module will provide trainees with the knowledge and understanding of the pathological basis of
disease and the use of Histopathology to detect and diagnose disease.
The trainees will become competent in the application of a range of techniques to case studies in
clinical practice and gain experience of interpreting results from patient investigations.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
7. Participate in the collection of a range of histopathology and cytopathology clinical specimens.
8. Perform investigations for the diagnosis, treatment and monitoring of named clinical conditions.
9. Evaluate and communicate the limitations of a range of investigative techniques in named clinical conditions.
10. Determine and give clinical advice on the sensitivity and specificity of investigative techniques in named clinical conditions.
11. Under supervision prepare and interpret reports that involve a range of histological and cytological techniques as part of the
systematic investigation of named clinical conditions.
12. Work in partnership with other clinical specialisms as part of the diagnosis and review of individual cases.
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CLINICAL EXPERIENTIAL LEARNING
The clinical experiential learning for this module is:
•
•
•
•
•
•
Prepare an evidence-based report listing the strengths and limitations of a range of investigative techniques used in named
clinical conditions.
Describe and apply evidence-based data on the sensitivity of investigative techniques in named clinical conditions. To include
suggesting clinical advice in specific clinical cases.
Working directly with a pathologist, discuss the systematic investigation that you have performed in named clinical conditions
on specimens from a range of clinical referrals. In each case agree how these may be incorporated into a report prepared in the
correct clinical context.
Participate in multidisciplinary review meetings at which histopathology results are presented as part of the clinical record.
Prepare a portfolio of cases to illustrate how key histological and cytological findings may be integrated with imaging and other
diagnostic findings to facilitate diagnosis and patient management in named clinical conditions.
Attend clinics and ward rounds where patients with named clinical conditions are investigated. Gain understanding of the
importance of Histopathology to the patient journey and write a reflective account of what you have learned.
Prepare a portfolio of cases from named clinical conditions where you have played a significant role in the systematic
investigation and include the use and interpretation of sensitivity and specificity data.
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional practice
competences alongside the competences defined in this module.
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KEY
LEARNING
OUTCOMES
1
2
4
3
COMPETENCES
Use a range of methods for the
identification and collection of tissue
and cellular preparations for the
microscopic investigation of named
common conditions, to include:
• needle biopsy
• surgical biopsy.
Interpret clinical requests and
associated specimens to prioritise
investigations, including the
identification of urgent cases.
Interpret clinical requests and
associated specimens from named
clinical conditions and plan the
investigations to be performed in
line with agreed protocol.
Prepare and perform macroscopic
examination and dissection of
specimens as part of systematic
investigation of named clinical
conditions, to include:
• macroscopic examination of
organs and tissues
• orientation and marking
• dissection and sampling of
category A to C specimens
according to local protocol
• macrophotography during
dissection
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
•
•
•
•
Dissection and sample preparation protocols for a wide range of
invasive and non-invasive sample types and identification of the
factors that influence the choice of invasive or non-invasive
technique, e.g. smears, aspirates, biopsies, excisions, resections.
Use of ultrasound to accurately identify biopsy site.
Clinical terminology for a variety of clinical conditions.
The relative seriousness of different clinical conditions and the need
for rapid results, e.g. cancer pathway, frozen sections while the
patient is in theatre, etc.
RCPath minimum data sets.
Awareness of the relationship between imaging and the histological
and cytological sample, e.g. ultrasound to identify the specific sample
site, and appreciate possible pitfalls.
Anatomy and physiology of normal tissues and organs.
Use of an example systemic pathway, e.g. urology, and follow agreed
protocols for dissection and sample preparation to obtain the best
result for the patient.
Limits of own practice and when to seek clinical advice.
RCPath minimum data sets.
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KEY
LEARNING
OUTCOMES
COMPETENCES
note taking during dissection
specialised containment to
prevent sample loss or crosscontamination
• containment of high-risk
samples
• recognition of own limits of
practice.
Prepare and section tissue blocks
and perform routine and specialised
procedures in line with systematic
investigation of named clinical
conditions, to include:
• routine and special stains
• decalcification of tissues
• immunocytochemistry
• in situ hybridisation
• molecular pathology.
Interpret routine and specialised
investigations performed and
recommend appropriate action, to
include:
• identification microscopically of
normal and abnormal tissue
• request specialised
demonstration techniques
• reporting.
KNOWLEDGE AND UNDERSTANDING
•
•
6
5,6
•
•
•
•
•
•
•
•
•
Rationale and protocols for a range of histological techniques.
Application of a range of sampling and staining techniques and using
them in a systematic way, relating them to the clinical presentation
and following agreed protocols, to ensure quality control is
maintained.
Quality assurance relating to techniques used.
Imaging techniques applied to tissue sections.
Microscopic appearance of normal and abnormal cells.
Appreciation of the importance of a timely and accurate
histopathology and cytopathology diagnosis in the clinical
management of the patient.
Appreciation of how the formatting of a report assists in the clinician
in understanding the findings.
Appreciation of the contribution of the results of other clinical
investigations and other pathology results.
Current legislation relating to the retention of cells, tissues and
organs.
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MODULE 3
AIM
SCOPE
Major Organ Histopathology excluding
Cancer (HP-4)
COMPONENT
Specialist
This module will provide trainees with the knowledge and understanding of the cellular structure and function
of the major organs and the cellular pathological findings in a range of clinical disorders other than cancer.
The trainee will become competent in the application of range of techniques to these clinical disorders and
gain experience in interpreting results from patient investigations. The trainee will be able to describe the
role of the clinical laboratory in major organ transplantation, including ethical and legal issues and the role
of immunosuppression.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
6. Identify and confirm clinical presentation of a range of major organ diseases.
7. Perform to quality standards a range of established histopathological techniques to named disorders of the major organs.
8. Identify and evaluate new equipment, methods or procedures to enhance the contribution of the histopathology laboratory to the
diagnosis and management of major organ disease.
9. Under supervision, prepare and interpret reports that involve histopathological findings as part of the investigation of major
organ disease.
10. Work in partnership with other clinical specialisms as part of the diagnosis and review of named clinical diseases of major
organs.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
CLINICAL EXPERIENTIAL LEARNING
The clinical experiential learning for this module is:
• Prepare an example histopathological report for a resection specimen and demonstrate the ability to discuss the essential
•
•
•
•
•
elements included.
Produce a portfolio demonstrating knowledge and understanding of dissection practice and how it relates to the diagnostic
process and subsequent patient care. Include details of investigations undertaken, with explanations, in the portfolio of cases
prepared for learning outcome 1.
Attend wards and clinics at which patients with named major organ disease are being investigated, and write a reflective account
of what you have learned.
Attend a multidisciplinary team meeting where patients with a major organ system disorder are being discussed and write a
reflective account of the experience.
Visit a laboratory involved in supporting organ transplantation and describe the interaction with the clinical transplant team. Write
a reflective account of your visit.
Prepare a portfolio of illustrative cases with a minimum of one from each listed major organ pathology. Include the plan of
laboratory investigation. To be developed further in learning outcomes 2 and 5.
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional practice
competences alongside the competences defined in this module.
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KEY
LEARNING
OUTCOMES
1
COMPETENCES
From routine requests, identify the
histopathological specimens
required to confirm a diagnosis in
each major organ system and
perform the relevant techniques to
process the sample.
Essential
• Dermatopathology
• Breast pathology
• Hepatobiliary pathology
• Gastrointestinal pathology
• Genitourinary pathology
• Respiratory pathology
• Gynaecological pathology
• Male reproductive pathology
• Endocrine pathology
2
Desirable
• Ear, nose and throat pathology
• Osteoarticular pathology
• Cardiac and vascular pathology
• Neuropathology.
Perform and record details of
macroscopic examination of tissue
received from named major organ
disease. To include:
Essential
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
The aetiology of and clinical presentation of a selection of common
tissue samples in named major organ disease (excluding cancer).
Impact on the patient pathway of the accuracy and timeliness of the
histological diagnostic process.
Anatomy and physiology of normal tissues and organs.
Appropriate methods of sample preparation and processing
protocols.
Impact upon the patient pathway of the accuracy of the description of
samples and its importance in the timeliness of the histological
diagnostic process.
Macroscopic appearance of a range of histological specimens
relating to common diseases in different organ systems (non-
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KEY
LEARNING
OUTCOMES
COMPETENCES
•
•
•
•
•
•
•
•
•
2
Dermatopathology
Breast pathology
Hepatobiliary pathology
Gastrointestinal pathology
Genitourinary pathology
Respiratory pathology
Gynaecological pathology
Male reproductive pathology
Endocrine pathology.
Desirable
• Ear, nose and throat pathology
• Osteoarticular pathology
• Cardiac and vascular pathology
• Neuropathology.
Perform to quality standards, basic
and appropriate specialised
histopathological techniques as part
of the systematic investigation of
tissue received from named major
organ disease. To include:
KNOWLEDGE AND UNDERSTANDING
•
•
•
cancer).
Specific dissection criteria applicable to specific disease conditions.
The requirements of quality-based diagnostic procedures in ensuring
safe and effective care of the patient.
Rationale of the histological techniques required to demonstrate the
different cell types involved in tissue sections from major organs.
Essential
• Dermatopathology
• Breast pathology
• Hepatobiliary pathology
• Gastrointestinal pathology
• Genitourinary pathology
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KEY
LEARNING
OUTCOMES
COMPETENCES
•
•
•
•
3
1,2,3
KNOWLEDGE AND UNDERSTANDING
Respiratory pathology
Gynaecological pathology
Male reproductive pathology
Endocrine pathology
Desirable
• Ear, nose and throat pathology
• Osteoarticular pathology
• Cardiac and vascular pathology
• Neuropathology.
Perform a detailed evaluation of one
new piece of equipment, method or
procedure.
Perform to quality standards
histopathological tests of rejection
from tissue grafts and/or organ
transplantation.
•
•
•
The impact of effective methodological assessment.
Use of controls.
Report writing.
•
Ethical and legal issues around transplantation and the role of
immunosuppression.
The role of the clinical laboratory in major organ transplantation,
including ethical and legal issues and the role of
immunosuppression.
Multi-organ transplantation and the microscopic appearance of
rejection.
Morphological presentation of a range of major organ systems.
Microscopic appearance of normal and abnormal cells.
Application of a wide range of histological techniques.
The importance of a timely and accurate histopathology and
cytopathology diagnosis in the clinical management of the patient.
How the formatting of a report assists in the clinician in
understanding the findings.
•
•
4
In discussion with a pathologist
interpret in the correct clinical
context the results of:
• macroscopic examination
• basic microscopic examination
• appropriate specialised
techniques
•
•
•
•
•
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KEY
LEARNING
OUTCOMES
COMPETENCES
•
4
KNOWLEDGE AND UNDERSTANDING
diagnostic algorithms.
from specimens received from a
range of named major organ
diseases, to include:
• dermatopathology
• breast pathology
• hepatobiliary pathology
• gastrointestinal pathology
• genitourinary pathology
• cardiac and vascular pathology
• respiratory pathology
• gynaecological pathology
• male reproductive pathology
• endocrine pathology
• ear, nose and throat pathology
• osteoarticular pathology.
In discussion with a pathologist,
•
prepare and issue reports from the
selected cases of named major
organ disease in the context of other
•
clinical information.
•
Impact on the patient pathway of the detail and accuracy of the
description within the diagnosis and its importance in the timeliness
of the treatment and management pathway of the patient.
How the formatting of a report assists in the clinician in
understanding the findings.
The contribution of the results of other clinical investigations and
other pathology results.
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MODULE 4
AIM
SCOPE
Cancer (HP-5)
COMPONENT Specialist
This module will provide trainees with the knowledge and understanding of the principles of
carcinogenesis, malignancy and metastasis. They will understand how to apply cellular pathology to the
diagnosis and management of a range of common cancers.
The trainee will become competent in the use of cellular pathology techniques in the initial diagnosis of
cancer and monitoring subsequent spread and will gain experience of interpreting results from patient
investigations. The trainee will be able to describe national and international targets and achievements
in the diagnosis, management and survival of cancer patients.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
9. Identify and confirm the clinical presentation of a range of common cancers.
10. Perform to quality standards a range of established histopathological techniques to named cancers.
11. Identify and evaluate new equipment, methods or procedures to enhance the contribution of the histopathology laboratory to the
diagnosis and management of cancer.
12. Apply diagnostic algorithms and prognostic indicators to the investigation and management of cancer patients.
13. Draft preparation and interpretation of reports that involve histopathological findings as part of the investigation of cancer.
14. Work in partnership with other clinical specialisms as part of the diagnosis and review of a range of common cancers.
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CLINICAL EXPERIENTIAL LEARNING
The clinical experiential learning for this module is:
• Participate in multidisciplinary review meetings at which histopathology results from cases of cancer are presented as part of the
•
•
•
•
•
•
clinical record. Wherever possible include those cases in your portfolio of named cancers. Record the outcomes of the
multidisciplinary review meetings.
Include details of investigations undertaken, with explanations, in the portfolio of cases prepared for learning outcome 1.
Perform a detailed evaluation of one new piece of equipment, method or procedure. Critically appraise the results of the
evaluation and produce a report with recommendations.
Participate in the application of the three different diagnostic algorithms and/or prognostic indicators to your portfolio of cases in
named cancers.
Write a histopathology report of a range of common cancers appreciating the partnership between the histopathology laboratory
and other clinical specialisms.
Suggest ways in which improved diagnostics could lead to better clinical outcomes in your three selected common cancers.
Prepare a portfolio of a minimum of 10 illustrative cases from different common malignancies. Include the plan of laboratory
investigation. To be developed further in learning outcomes 2 and 6.
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional practice
competences alongside the competences defined in this module.
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KEY
LEARNING
OUTCOMES
1
COMPETENCES
Plan and implement, using aetiology
and clinical presentation
information, a diagnostic process to
identify common cancers and their
prognosis.
Essential
• Skin malignancy
• Breast malignancy
• Hepatobilary malignancy
• Gastrointestinal malignancy
• Genitourinary malignancy
• Respiratory malignancy
• Gynaecological malignancy
• Male reproductive malignancy
• Endocrine malignancy.
2
Desirable
• Haemopoietic malignancy
• Neuromuscular malignancy
• Ear, nose and throat malignancy
• Osteoarticular malignancy
• Vascular malignancy
• Neurological malignancy.
Perform the examination of and
record details of the macroscopic
examination of tissue received from
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
•
The whole patient pathway and appreciation of the role
Histopathology plays in improving outcomes for patients and the
importance of providing an early and accurate diagnosis to enable
treatment/resection decisions to be made.
Biology of normal and abnormal cell growth.
Homeostasis tumour growth, angiogenesis, apotosis and metastasis.
Role of oncogenes in cancer development and molecular basis of
oncogenesis.
Mechanisms of clinical and surgical treatments for cancer.
Dissection protocols, anatomy and physiology.
Normal and abnormal macroscopic appearance of a range of tissue
types.
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KEY
LEARNING
OUTCOMES
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
named cancers.
Essential
• Skin malignancy
• Breast malignancy
• Hepatobilary malignancy
• Gastrointestinal malignancy
• Genitourinary malignancy
• Respiratory malignancy
• Gynaecological malignancy
• Male reproductive malignancy
• Endocrine malignancy.
1
2
Desirable
• Haemopoietic malignancy
• Neuromuscular malignancy
• Ear, nose and throat malignancy
• Osteoarticular malignancy
• Vascular malignancy
• Neurological malignancy.
Perform dissection and sample
cancer resection specimens
received in accordance with local
protocols.
Perform to quality standards basic
and appropriate specialised
histopathological techniques as part
of the systematic investigation of
•
•
Anatomy and physiology of normal tissues and organs.
The macroscopic appearance of cancer in a selection of different
tissues.
•
•
Rationale and protocols for histological techniques.
Quality control/external quality assurance.
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KEY
LEARNING
OUTCOMES
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
tissue received from a minimum of
10 different named cancers.
3
Use and evaluate new equipment
relevant to the histological
investigation of cancer.
•
Methodology for assessing new pieces of equipment and introducing
new techniques in comparison to existing methodologies.
4
Present orally the evidence base for
three different diagnostic algorithms
and/or prognostic indicators used by
your unit in the investigation and
management of cancer patients.
•
Application of diagnostic algorithms and prognostic and predictive
indicators to the investigation and management of cancer patients.
5.
Identify and interpret national and
international cancer targets and
survival statistics for at least three
common cancers.
•
Application of national and international targets and achievements in
the diagnosis, management and survival of cancer patients.
Genetic aspects of predisposition to cancer.
In discussion with a pathologist
interpret in the correct clinical
context the results of:
•
4,5
macroscopic examination
basic microscopic examination
appropriate specialised
techniques
• diagnostic algorithms.
from specimens received from a
range of named cancers.
•
•
•
•
•
•
•
•
•
•
•
Identification of normal and abnormal cells and tissue structures
using light microscopy.
The formulation of a histopathology report to include all of the
different elements required by minimum cancer data sets.
RCPath guidelines.
The role of multidisciplinary team meetings.
The principles of radioactive and chemical carcinogenesis.
The role of radiotherapy and chemotherapy in the treatment of
cancer.
The importance of monitoring some cancers with biochemical and
haematological markers.
The clinical care involved with looking after patients with cancer.
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KEY
LEARNING
OUTCOMES
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
To include:
Essential
• Skin malignancy
• Breast malignancy
• Hepatobilary malignancy
• Gastrointestinal malignancy
• Genitourinary malignancy
• Respiratory malignancy
• Gynaecological malignancy
• Male reproductive malignancy
• Endocrine malignancy.
Desirable
• Haemopoietic malignancy
• Neuromuscular malignancy
• Ear, nose and throat malignancy
• Osteoarticular malignancy
• Vascular malignancy
• Neurological malignancy.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
MODULE 5
AIM
SCOPE
Specialised Histopathology (HP-6)
COMPONENT Specialist
This module will provide trainees with the knowledge and understanding of the application of specialised
histopathology techniques to subspecialised specimens in clinical situations, including electron
microscopy and autopsy.
The trainee will become competent in the use of specialised cellular pathology techniques in clinical
situations and gain experience of interpreting results from patient investigations.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
1. Identify the clinical presentation of a range of relevant disorders of specialised organ groups and clinical subspecialist areas.
2. Perform to quality standards a range of specialised histopathology techniques.
3. Identify and evaluate new equipment, methods or procedures to enhance the contribution of the histopathology laboratory to the
diagnosis and management of specialised organ groups and clinical subspecialist areas.
4. Support the organisation and use of specialised histopathology laboratory services in the UK.
5. Under supervision, prepare and interpret histopathology reports that involve specialised organ groups and clinical subspecialist
areas.
6. Support mortuary operation, the autopsy process and the associated regulatory framework. Where appropriate, observe
autopsy in action.
7. Work in partnership with other clinical specialisms as part of the diagnosis and review of patients with disorders of specialised
organ groups and from clinical subspecialist areas.
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CLINICAL EXPERIENTIAL LEARNING
The clinical experiential learning for this module is:
• Participate in multidisciplinary review meetings at which histopathology results from relevant specialised areas of medicine are
•
•
•
•
•
presented as part of the clinical record. Wherever possible include those cases in your portfolio. Record the outcomes of the
multidisciplinary review meetings.
Perform a detailed evaluation of one new piece of equipment, method or procedure. Critically appraise the results of the
evaluation and produce a report with recommendations.
Participate in the referral of five specimens for different specialised histopathology investigations and gain an understanding of
the importance of the report returned in the context of patient diagnosis and/or management.
Visit and be able to describe the role and operation of an NHS mortuary. If possible attend an autopsy examination and gain an
understanding of the roles undertaken by the pathologist and by the anatomical pathology technologist.
Attend wards and clinics at which patients from relevant specialised areas of medicine are being investigated and write a
reflective report.
Prepare a portfolio of illustrative cases with a minimum of one from each listed specialised area of pathology. Include the plan of
laboratory investigation. Include details of investigations undertaken, with explanations, and details of results, interpretation and
reports with explanations, in the portfolio of cases prepared for learning outcome 1 and 5.
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional practice
competences alongside the competences defined in this module.
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KEY
LEARNING
OUTCOMES
1
2
2
2
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
From routine requests, identify the
histopathological specimens
required to confirm a diagnosis for:
• ophthalmic pathology
• neuromuscular pathology
• central nervous system
pathology
• haemopoietic pathology.
Perform and record details of
macroscopic examination of tissue
received from named diseases of:
• ophthalmic pathology
• neuromuscular pathology
• central nervous system
pathology
• haemopoietic pathology.
Dissect and sample specimens
received in accordance with local
protocols.
•
Perform to quality standards basic
and appropriate specialised
histopathological techniques as part
of the systematic investigation of
tissue received from named
diseases of:
• ophthalmic pathology
• neuromuscular pathology
•
The particular difficulties relating to the handling of these specialist
specimens and the main diagnostic reasons for the clinical
investigations.
The aetiology of and clinical presentation in named diseases.
•
•
Specific dissection criteria applicable to specific disease conditions.
Different tissue processing regimens.
•
Dissection protocols and standard operating procedures.
•
•
Rationale and protocols for relevant specialised techniques.
Quality control/external quality assurance.
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KEY
LEARNING
OUTCOMES
COMPETENCES
central nervous system
pathology
• haemopoietic pathology.
Identify and describe relevant new
equipment, methods or procedures
that may be able to enhance the
contribution of the histopathology
laboratory specialised areas of
medicine.
KNOWLEDGE AND UNDERSTANDING
•
3
•
•
Methodology for assessing new pieces of equipment and introducing
new techniques in comparison to existing methodologies.
The operating protocols for an electron microscope.
4
Report on the UK centres
undertaking specialised
histopathology investigations, giving
examples from your own experience
of the specialised tests provided in
named disorders.
•
List of specialised diagnostic services provided locally, regionally,
supra-regionally and nationally.
5,7
In discussion with a pathologist
interpret in the correct clinical
context the results of:
• macroscopic examination
• basic microscopic examination
• appropriate specialised
techniques
• diagnostic algorithms
from specimens received from a
range of named specialist systems,
to include:
• ophthalmic pathology
•
•
•
RCPath guidelines.
The role of multidisciplinary team meetings.
The importance of monitoring some cancers with biochemical and
haematological markers.
The clinical care involved with looking after patients with specialised
conditions.
Appreciation of how the formatting of a report assists the clinician in
understanding the findings.
Appreciation of the contribution of the results of other clinical
investigations and other pathology results.
•
•
•
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KEY
LEARNING
OUTCOMES
COMPETENCES
•
•
•
6
KNOWLEDGE AND UNDERSTANDING
neuromuscular pathology
central nervous system
pathology
haemopoietic pathology.
Identify and apply the relevant
legislation and guidance that applies
to the autopsy and the retrieval of
tissue.
•
•
•
The requirements of the Human Tissue Act (2004) and the Codes of
Practice of the Human Tissue Authority.
Clinical Pathology Accreditation (UK) Ltd standards.
MHRA guidelines.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
Cellular Sciences
SECTION 8: SPECIALIST LEARNING FRAMEWORK
REPRODUCTIVE SCIENCE
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
STP Learning Framework
This section describes the Learning Framework for the Specialist Component of work based learning
covering the Learning Outcomes, Clinical Experiential Learning, Competence and Applied Knowledge
and Understanding. Each trainee is also expected to build on and apply the knowledge, skills and
experience gained from the MSc in Clinical Science.
Specialist Modules
DIVISION
Life Sciences
THEME
Cellular Sciences
SPECIALISM
Reproductive Science
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
REPRODUCTIVE SCIENCE – SPECIALIST MODULES
Module 1 (RS-2)
Infertility, Treatment and Role of Regulation
Module 2 (RS-3)
Gametes and Fertilisation
Module 3 (RS-4)
Culture of Gametes and Embryos
Module 4 (RS-5)
Micromanipulation and Cryopreservation
Module 5 (RS-6)
Embryology
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
MODULE 1 Infertility, Treatment and Role of Regulation
COMPONENT Specialist
(RS-2)
This module will provide the trainee with the knowledge and understanding of the causes and treatment
AIM
SCOPE
options for male and female infertility and the approach to managing the infertile couple. They will
understand the role of regulation in treating infertility and become familiar with legislatory and quality
management aspects of licensed treatments.
On completion of this module the trainee will have gained further experience of involvement in clinical
appointments and multidisciplinary team meetings to improve their understanding and skills in the
investigation and treatment of infertility. They will be able to perform a range of procedures and quality
assurance tasks associated with working within the infertility clinical laboratory.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
1. Suggest a patient’s pathway, including treatment options and stimulation regimens based on clinical presentation.
2. Perform procedures within the statutory and regulatory framework.
3. Perform quality management tasks.
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CLINICAL EXPERIENTIAL LEARNING
The clinical learning experience for this module is:
• Attend clinical appointments to gain experience of the clinical presentation of male and female infertility (with the permission of
•
•
•
•
•
patients). Evaluate your experience in terms of both the clinical presentation and patient experience/needs and discuss with your
supervisor.
Attend clinical appointments to gain experience and review the range of treatment options for the infertile couple (with the
permission of the patient). This may include attendance at initial medical consultation, nurse consultation or follow-up
consultation within the clinical setting of the assisted conception unit.
Shadow at least one patient pathway to gain experience of the endocrine and physiological responses to different ovarian
stimulation regimens and discuss the clinical situations in which each would be used, the monitoring undertaken and patient
safety considerations.
Attend multidisciplinary team meetings to participate in case discussion to review a wide range of clinical cases.
Select one case discussion and review in more detail, following patient progress and actual/potential outcomes, to include the
clinical presentation, options considered, treatment provided and patient engagement and experience in the process.
Attend multidisciplinary team meetings to gain experience and describe the partnership between the reproductive science
laboratory and other clinical specialisms in the investigation of infertility, for example Clinical Genetics.
LABORATORY EXPERIENTIAL LEARNING
• Become familiar with the laboratory quality management system and perform examination and other audits as part of the
laboratory accreditation process (applies as appropriate to all specialist modules).
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional practice
competences alongside the competences defined in this module.
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KEY
LEARNING
OUTCOMES
1
COMPETENCES
Review case notes to link the cause
of infertility with the suggested
treatment plan and produce an
interpretive report of the
investigations.
KNOWLEDGE AND UNDERSTANDING
•
•
•
1
2
2
3
3
2,3
Plan and optimally time a
thaw/warming cycle within a natural
or hormone replacement therapy
(HRT) cycle.
Perform witness checks during a
procedure to meet Human
Fertilisation and Embryology
Authority (HFEA) requirements.
Review the required consents
appropriate for a variety of treatment
cycles, including those involving
donated gametes.
Perform quality assurance and
quality control tasks within the
laboratory.
Perform and report a risk
assessment for one procedure
performed in your laboratory.
Follow the appropriate guidelines for
incident reporting within the centre.
•
•
•
•
Basic knowledge of the cause and diagnosis of male and female
infertility.
Awareness of the different stimulation regimens with respect to their
mode of action and the reasons why they are used in different clinical
situations.
Awareness of the key factors in the case history that may influence
the choice of treatment options.
Requirements for interpretive reporting.
Awareness of when natural and HRT cycles are used for
thaw/rewarming cycles.
Working knowledge of the menstrual cycle/endocrinology in order to
time when embryos are replaced in frozen/thawed cycles.
In-depth knowledge of the HFEA Code of Practice with respect to
witnessing requirements and the implications of incorrect witnessing
procedures.
•
In-depth knowledge of which consents are applicable to treatment
options for local and HFEA Code of Practice requirements. The
importance of accurately completing and checking consent forms.
•
Working knowledge of the principles of quality management,
validation and quality control and assurance, and the benefits of both
external and internal quality assurance.
The importance of performing risk assessment and the implications
of non-compliance with requirements.
•
•
A comprehensive knowledge of local clinical governance procedures
as well as HFEA requirements.
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KEY
LEARNING
OUTCOMES
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
•
2
Minimise risks and hazards in
compliance with health and safety
policies.
•
The type and range of potential incidents, their causes and control
measures.
The relevant health and safety regulations and the potential hazards
and risks and the actions taken to minimise these.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
MODULE 2
AIM
SCOPE
Gametes and Fertilisation (RS-3)
COMPONENT Specialist
This module will provide the trainee with the knowledge and understanding of the development of male
and female gametes and the process of fertilisation. They will understand and gain experience in egg
collection, sperm preparation and insemination methodologies, and identify normally and abnormally
fertilised oocytes. The trainee will also learn how to report results from insemination/fertilisation.
On completion of this module the trainee will have gained experience in a range of procedures,
including sperm assessment and preparation, egg collection, in vitro fertilisation insemination and
identifying oocytes for normal and abnormal fertilisation. They will be able to communicate results with
the multidisciplinary team and patients.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
1.
2.
3.
4.
Handle gametes correctly to maintain viability.
Undertake an egg recovery procedure and identify oocytes.
Perform the different methods of sperm preparation techniques.
Identify patients who, based on clinical parameters, require either in vitro fertilisation (IVF) or intracytoplasmic sperm injection
(ICSI).
5. Advise patients on their treatment pathway through discussion of the different insemination methods. Perform the different
methods of routine (not ICSI) insemination.
6. Identify stages of oocyte maturity and normally and abnormally fertilised oocytes.
7. Record and report accurately patients’ fertilisation results.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
CLINICAL EXPERIENTIAL LEARNING
The clinical learning experience for this module is:
•
•
•
•
•
Review patient notes where the course of treatment has been changed with regard to method of insemination. Reflect on the
reasons for change and the intended/actual improvements in treatment outcomes for the patient. Discuss with your
supervisor.
Attend multidisciplinary team meetings to review and discuss cases of failed fertilisation to recommend further treatment
options. Reflect on the reasons for failure, the recommendations and potential outcomes, and the impact of failure on the
patient experience. Discuss with your supervisor.
Review presenting cases and prepare to discuss with clinical colleagues the presenting infertility causes that would indicate
the methods of insemination. Prepare your own recommendations, with rationale for discussion, and reflect on the outcomes
of review with colleagues.
Review cases where insemination has not taken place post egg recovery and discuss the reasons for this with your
colleagues and supervisor. Reflect and review the discussion and implications for your own future practice.
Review patients’ notes where donated gametes have been used. Review and discuss the patient pathway, including why
donor gametes were required, the counselling and consent process. Consider from both the specialist and patient
perspectives.
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional practice
competences alongside the competences defined in this module.
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STP_LG Cellular Sciences 2012-2013 Final Version (4.0)
KEY
LEARNING
OUTCOMES
5
COMPETENCES
Discuss insemination methods used
in treatment based on semen quality
with patients.
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
1,4
Make a clinical decision regarding
the method of insemination with
respect to semen quality.
•
•
•
6
Label and witness samples used for
insemination.
•
3
Prepare epididymal and testicular
samples for use with ICSI.
Perform and interpret swim-up
techniques and density gradient
•
1,3,4
•
Information needs of a patient and the implications of consent.
The importance of preparing for discussion with patients, including
review of specific case histories.
In-depth knowledge of the clinical reasons when ICSI is used with
regard to semen quality and previous treatment outcomes.
Comprehensive knowledge of the methods involved in IVF and ICSI
and the advantages, disadvantages and risks of each method and
the implications of failed fertilisation.
Basic knowledge of when it is necessary to consider the use of donor
sperm and the regulatory requirements associated with donor
gamete use.
Common questions and concerns of the patient about procedures.
In-depth knowledge of the reasons why ICSI may be recommended
as a treatment option and the resulting effects on the patient
treatment pathway.
In-depth knowledge of the risks and the importance of the regulations
associated with ICSI.
Factors influencing a clinical decision and the required decisionmaking process.
A comprehensive knowledge of the Human Fertilisation and
Embryology Authority (HFEA) Code of Practice with respect to
witnessing requirements and the implications of incorrect witnessing
procedures.
Basic knowledge of male anatomy and the physiology of mature
sperm, and implications of using immature sperm for ICSI.
In-depth knowledge of the World Health Organization (WHO) criteria
for normal and abnormal semen parameters.
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KEY
LEARNING
OUTCOMES
2
COMPETENCES
separation of sperm samples of
different quality, including:
• antisperm antibody-positive
samples
• retrograde samples
• severe oligoasthenozoospermic
samples
• frozen samples, including donor
samples.
Identify granulosa cells, cumulus
cells and oocytes during egg
collection.
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
•
2
1
Identify cysts during an oocyte
collection.
Handle and manipulate oocytes to
maintain viability.
•
•
•
•
•
6
Perform the identification and
witnessing checks carried out at the
time of insemination for IVF and
ICSI.
•
6
Perform insemination for IVF.
•
In-depth knowledge of the importance of how suboptimal samples
may affect fertilisation rates.
Basic knowledge of the aetiology of male factor infertility.
Comprehensive knowledge of the different methods that can be
applied to prepare semen samples of differing qualities.
Working knowledge of how cryoprotectants may affect the quality of
sperm and how osmotic shock may occur during the process.
Implications of incorrect use of cryoprotectants on sample quality and
outcomes.
Basic knowledge of follicular physiology and oocyte maturation in
vivo. Awareness of the egg retrieval procedure and factors that could
impair oocyte quality during the procedure.
Awareness of the correct timing and administration of chorionic
gonadotrophin to complete oocyte maturation and the implications for
treatment.
Awareness of the different types of cysts and why they may arise.
Recognition of type and implications for further processing/treatment.
The importance of aseptic techniques and maintaining sterility.
Implications of incorrect application of aseptic technique and the
potential risks.
Working knowledge of the environmental variables such as
temperature and CO2 and their impact on sample viability.
A comprehensive knowledge of the HFEA Code of Practice with
respect to witnessing requirements and the implications of incorrect
witnessing procedures.
An in-depth knowledge of methods of insemination and implications
for the fertilisation rate and treatment outcome if the wrong method
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KEY
LEARNING
OUTCOMES
1,7
1,7
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
Perform cumulus removal before
ICSI and categorise the state of
maturity of denuded oocytes.
•
Perform fertilisation checks.
•
•
•
8
8
7
Communicate bad news to patients
in the event of low or failed
fertilisation.
•
Discuss fertilisation results with
patients and the multidisciplinary
team.
Correctly identify and record normal
and abnormally fertilised oocytes.
•
•
•
•
or concentration of sperm is used.
In-depth knowledge of the different stages of oocyte maturation and
the implications of immature oocytes for ICSI procedure.
Working knowledge of the enzymatic process involved in the process
of cumulus removal.
In-depth knowledge of normal and abnormal fertilisation, including
failed fertilisation of the oocyte.
Comprehensive knowledge of pronuclear formation and the
completion of the second meiotic division.
A working knowledge of the reasons why fertilisation may not occur
and how to deliver bad news to patients.
Awareness of when it is necessary to consider the use of donor
sperm/oocytes and the regulatory requirements associated with
donor gamete use.
The importance of communicating scientific information in an
understandable manner to patients and colleagues.
The importance of accurately identifying and recording normal and
abnormally fertilised oocytes.
Implications of replacing an abnormally fertilised embryo back in a
patient and the implications for treatment outcome.
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Module 3
AIM
SCOPE
Culture of Gametes and Embryos (RS-4)
COMPONENT Specialist
This module will provide the trainee with the knowledge and understanding of the principles and practice
of culture systems used in an in vitro fertilisation laboratory. They will gain experience of the culture of
gametes and embryos in a clinical setting. They will gain understanding on how quality management
integrates with the laboratory processes, and how to identify, troubleshoot and correct problems.
On completion of this module the trainee will have gained experience in a variety of culture systems by
preparing the dishes and tubes used to culture gametes and embryos within the laboratory and by
visiting other centres that use different systems. They will have taken part in a range of quality
management tasks to perform system evaluations.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
1.
2.
3.
4.
5.
Use sterile technique to prepare culture dishes appropriate for gametes and embryos.
Culture embryos to maintain viability.
Perform quality control checks within the laboratory.
Analyse key performance indicators with respect to defined outcomes.
Identify, troubleshoot and solve problems.
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CLINICAL EXPERIENTIAL LEARNING
The clinical learning experience for this module is:
•
•
•
Visit at least two reproductive science laboratories other than your own to review the different clinical settings and culture
systems used to support embryo development. Reflect on your experience in terms of the differentiation between them and
consider how this influences your future practice.
Evaluate and discuss the different types of culture systems used, including the implications for selection, processing and
outcome. Evaluate the impact on your future practice,
Participate in multidisciplinary team meetings to present and review key performance indicators. Identify at least one potential
problem and how to troubleshoot with clinical colleagues. Discuss at a multidisciplinary team meeting, review your experience
and the impact on both the patient experience, and your own future practice.
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional practice
competences alongside the competences defined in this module.
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KEY
LEARNING
OUTCOMES
1,2
2
1
COMPETENCES
Assess air quality in the laboratory.
Correctly use incubators, heated
stages and tube warmers to
maintain temperature conditions.
Use workstations/safety cabinets
correctly to maintain sterility of
samples.
KNOWLEDGE AND UNDERSTANDING
•
•
•
•
•
•
•
•
1
1,2
3,4,5
Perform sterilisation and
decontamination techniques for
equipment and facilities used in
tissue culture.
Prepare consumables and media for
oocyte collection; fertilisation
checks; embryo culture; embryo
transfer; embryo cryopreservation
and thawing/warming.
Analyse data required for specific
•
•
•
•
•
•
•
The importance of air quality and the implications for maintaining
sterility. An awareness of methodology to assess air quality such as
particulate counts, microbiological testing and volatile organic
compound (VOC) measurements.
A working knowledge of regulatory requirements.
The importance of controlling the culture environment and the
implications for embryo viability if suboptimal conditions are used.
Working knowledge of the measurements that can be taken to
assess parameters directly affecting embryo quality and the
implications of exceeding tolerance limits.
Identification of common faults and remedial action.
The importance of aseptic techniques and maintaining sterility.
Implications of incorrect application of aseptic technique and the
potential risks.
Working knowledge of the environmental variables, such as
temperature and CO2, and their impact on sample viability.
Identification of common faults and remedial action.
The importance of aseptic techniques and maintaining sterility.
Implications of incorrect application of aseptic technique and the
potential risks.
Protocols and requirements for hygiene and infection control.
An in-depth knowledge of water purity, osmolality, pH, temperature,
protein supplements, antibiotics and microbiological contamination
and their effects on oocyte and embryo viability in culture.
A comprehensive knowledge of the physiological requirements of an
embryo at the different stages of development in culture.
In-depth knowledge of data analysis for KPIs and defining tolerance
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KEY
LEARNING
OUTCOMES
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
key performance indicators (KPIs)
•
3
Perform inward receipt of
consumables to carry out the
necessary quality control checks
and traceability requirements.
•
limits.
The importance of recognising non-compliances and the implications
for the system.
A working knowledge of the regulatory requirements and quality
issues relating to consumables used in the laboratory.
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Module 4
AIM
SCOPE
Micromanipulation and Cryopreservation
(RS-5)
COMPONENT
Specialist
This module will provide the trainee with the knowledge and understanding of the principles and practice
of micromanipulation and cryopreservation and associated regulatory requirements. They will gain
experience of the micromanipulation and cryopreservation of gametes and embryos in a clinical setting.
On completion of this module the trainee will have gained experience of performing intracytoplasmic
sperm injection (ICSI) and be able to make a clinical decision as to when a patient requires ICSI. They
will be able to cryopreserve gametes and embryos and thaw/rewarm samples for use in treatment
cycles.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
1. Perform micromanipulation techniques.
2. Perform cryopreservation and thawing/warming of gametes and embryos.
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CLINICAL EXPERIENTIAL LEARNING
The clinical learning experience for this module is:
•
•
Participate in multidisciplinary team meetings and discuss when intracytoplasmic sperm injection (ICSI) should be used in
treatment. Identify one case study relating to this decision-making process, prepare and discuss with the multidisciplinary team.
Reflect on the discussion and outcomes and the impact for your future practice.
Participate in audits to gain experience of the statutory and regulatory requirements of cryopreservation, including the review of
patients with stored material, consent checking and billing process. Reflect on the importance of audits to comply with
regulation and to inform patients of their choices with respect to continued storage. The quality of the process and the
importance/options/action.
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional practice
competences alongside the competences defined in this module.
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KEY
LEARNING
OUTCOMES
1
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
Label and perform witnessing prior
to micromanipulation of oocytes.
•
1
Use correctly the micromanipulation
equipment.
•
1
Perform ICSI.
•
2
Label and perform witnessing prior
to cryopreservation and following
thawing/warming of semen, oocytes
and embryos.
Perform sperm cryopreservation.
•
2
•
•
•
•
2
Thaw semen samples and compare
pre-freeze and post-thaw
parameters.
•
•
A comprehensive knowledge the Human Fertilisation and
Embryology Authority (HFEA) Code of Practice with respect to
witnessing requirements and the implications of incorrect witnessing
procedures.
The importance of correctly setting up and using ICSI equipment and
the implications for oocyte viability of setting up incorrectly. Working
knowledge of the equipment used for ICSI and troubleshooting
techniques.
Comprehensive knowledge of the methodology of the process,
including sperm selection and immobilisation, positioning of the polar
body and the injection process.
A comprehensive knowledge the HFEA Code of Practice with
respect to witnessing requirements and the implications of incorrect
witnessing procedures.
In-depth knowledge of the required consents that need to be
completed before any samples can be stored and the implications for
the centre if consents are not completed.
In-depth knowledge of the principles of cryobiology, including the
physical and chemical processes occurring during cryopreservation
and thawing, and the use and properties of cryoprotectants.
Working knowledge of the health and safety regulations to be applied
when handling liquid nitrogen.
Comprehensive knowledge of the regulatory requirements with
regard to screening and storage limits.
Working knowledge of how cryoprotectants may affect the quality of
sperm and how osmotic shock may occur during the process.
Implications of incorrect use of cryoprotectants on sample quality and
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KEY
LEARNING
OUTCOMES
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
•
2
Perform embryo freezing and
embryo vitrification.
•
•
•
2
2
2
Thaw cryopreserved samples and
warm vitrified samples.
Release and receive cryopreserved
gametes and embryos to other
centres.
•
Discuss embryo development with
patients and the multidisciplinary
team with specific reference to the
suitability for cryopreservation and
the survival.
•
•
•
outcomes.
In-depth knowledge of the physiological changes that occur in
gametes during cryopreservation.
In-depth knowledge of principles of cryobiology, including the
physical and chemical processes occurring during slow rate freezing
and vitrification, and the use and properties of cryoprotectants.
The methods used and the consumables that are available for
different methods.
In-depth knowledge of the regulatory requirements with regard to
screening, storage limits and consent.
In-depth knowledge of the physiological changes that occur in
gametes and embryos during thawing/rewarming.
In-depth knowledge of the regulatory requirements with regard to
moving samples between centres.
Importance of maintaining appropriate conditions during transport to
ensure viability is not compromised.
In-depth knowledge of the effect of cryopreservation on embryo
quality and the implications of quality in relation to treatment
outcome.
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Module 5
AIM
SCOPE
Embryology (RS-6)
COMPONENT Specialist
This module will provide the trainee with the knowledge and understanding of the development of preimplantation embryos. They will gain experience of the morphological assessment of embryos and the
assessments used to identify embryos for transfer or cryopreservation.
On completion of this module the trainee will have gained experience in the methods used to assess
embryos and be able to select embryos for transfer and cryopreservation. They will be able to discuss
embryo quality with colleagues and patients and be able to apply the multiple births minimisation
strategy.
LEARNING OUTCOMES
On successful completion of this module the trainee will:
1. Perform oocyte and embryo morphology assessments.
2. Perform embryo transfer.
3. Assess, interpret and report embryology results.
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CLINICAL EXPERIENTIAL LEARNING
The clinical learning experience for this module is:
• Identify a case involving a difficult embryo transfer, consider the options available and review and discuss with your supervisor.
Consider the implications for the patient and how the results of your discussion will inform your future practice.
• Attend a medical follow-up consultation to gain experience of cycle analysis, consider possible options and discuss future
decisions for patient treatment. Reflect on the implications for patient experience/outcome and the impact on your own future
practice.
• Review the embryology detail of at least one patient treatment, evaluate the cycle and prepare a report that could be entered
into a patient’s clinical notes. Review and discuss with your supervisor.
• Prepare a portfolio of significant clinical cases where you have been involved in performing laboratory investigations and/or
reporting. Discuss and review the clinical outcome and main learning points for each case.
All of these experiences should be recorded in your e-portfolio.
The following section details the competence and knowledge and understanding each trainee must gain. Each competence is
linked to the relevant learning outcomes and trainees must demonstrate achievement of each competence for each linked learning
outcome.
PROFESSIONAL PRACTICE
Trainees should ensure they refer to the professional practice learning framework and continue to achieve the professional practice
competences alongside the competences defined in this module.
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KEY
LEARNING
OUTCOMES
1
1,3
COMPETENCES
KNOWLEDGE AND UNDERSTANDING
Grade embryos both at the cleavage •
stage and the blastocyst stage.
Accurately record embryo grading
•
and outcome.
•
1,2,3
Label, identify and witness embryos
for use in embryo transfer.
•
2
Use procedures and workstations to
maintain embryo viability during
embryo transfer.
•
•
•
1,3
Dispose of unused embryos.
1,3
Make clinical decisions regarding
•
the number of embryos to be
transferred.
Communicate number of embryos to •
be transferred to patients.
•
1,3
•
In-depth knowledge of human embryonic development and
differentiation at all stages of the pre-implantation embryo.
The importance of participating in internal and external quality
assurance.
The importance of the assessment of embryos intended for treatment
and the effect embryo quality has on cycle outcome.
A comprehensive knowledge the Human Fertilisation and Embrology
Authority (HFEA) Code of Practice with respect to witnessing
requirements and the implications of incorrect witnessing
procedures.
The importance of aseptic techniques and maintaining sterility.
Implications of incorrect application of aseptic technique and the
potential risks.
Working knowledge of the environmental variables, such as
temperature and CO2, and their impact on sample viability.
The importance of documentation and informing patients of fate of
individual embryos.
In-depth knowledge of the HFEA regulations with regard to multiple
births.
In depth knowledge of the HFEA regulations with regard to multiple
births
Awareness of the multiple births minimisation strategy and the risks
associated with multiple births.
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Cellular Sciences
SECTION 9: CONTRIBUTORS
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Contributor List
Members of the STP Work Based Learning Guide Development Group for Life
Sciences: Cellular Sciences
Production of the STP work based learning guides for Cellular Sciences has been
coordinated by the Modernising Scientific Careers team and the National School of
Healthcare Science working with NHS colleagues. The professionals who have
contributed to the development of this Learning Guide include:
Jane
Rachel
Anne
Nick
Barbara
Julia
Behdad
Ian
Allan
Blower
Cutting
Goodall
Kirk
Lloyd
Sarson
Shambayati
Sturdgess
Wilson
University Hospitals of Leicester NHS Trust
Sheffield Teaching Hospitals
Oxford Radcliffe NHS Hospitals Trust
Papworth Hospital, Cambridge
Addenbrooke's Hospital, Cambridge
Oxford Radcliffe NHS Hospitals Trust
Ashford Hospital. Kent
Addenbrooke's Hospital, Cambridge
Monklands Hospital, Airdrie
Professional bodies and societies were invited to review the Learning Guides for
Cellular Sciences and their feedback has shaped the final publication:
Association of Cytopathology
Institute of Biomedical Science
Association of Clinical Biochemists: Clinical Microbiology Section
Modernising Scientific Careers Professional Advisor
Dr Graham Beastall
Ms Nicky Fleming
National School of Healthcare Science Professional Lead
Dr Barbara Lloyd
September 2012
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Cellular Sciences
SECTION 10: APPENDICES
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APPENDIX 1: GLOSSARY
Term
Clinical Experiential
Learning
Clinical Experiential
Learning Outcomes
Competence
Competence
statements
Component
Curricula
Division
Domains of Learning
Feedback
Good Scientific
Practice
Host Department
Job
Key Learning
Outcome
Knowledge and
Understanding
Learning Framework
Learning Module
Definition
The cyclical process linking concrete experience with abstract
conceptualisation through reflection and planning.
The activities that the trainee will undertake to enable and
facilitate their learning in the workplace.
The ability of an individual to perform a role consistently to
required standards combining knowledge, understanding, skills
and behaviour.
Active and outcome-based statements that provide a further
breakdown of the Learning Outcomes –reflecting what the
trainee will be able to do in the workplace at the end of the
programme. Each competence should linked back to the
numbered Learning Outcomes.
An indication of the type of module within a learning guide ie;
rotational, specialist or elective
An outline of the expected educational outcomes across a
subject area The learning that is expected to take place during
the Scientist Training Programme described in terms of
knowledge, skills and attitudes,
A high level description of an area of practice within healthcare
science. There are three divisions: Life Sciences, Physical
Sciences and Biomedical Engineering and Physiological
Sciences.
Cognitive (knowledge and intellectual skills), affective (feelings
and attitudes), interpersonal (behaviour and relationships with
others) and psychomotor (physical skills)
Specific information about the comparison between a trainee’s
observed performance and a standard, given with the intent to
improve the trainee’s performance (van de Ridder JMM,
Stokking KM, McGaghie WCand ten Cate OT. What is
feedback in clinical education? Medical Education 2008: 42:
189–19)7
Non-statutory guidance on the minimum requirements for good
practice for the healthcare science workforce.
The department which is responsible for the 3-year training
programme and which the training officer is based.
A specific definition of the work activities, requirements, skills
required to undertake work activities within a local context.
This differs from a role – see below.
A defined learning outcome linked to relevant competence(s)
within the workplace Learning Guide
The knowledge and understanding that must be applied in the
work place to achieve the stated competence.
The specification for work based learning contained within the
Learning Guide
A distinct set of learning outcomes and competences that form
part of a programme. Modules may be rotational, specialist,
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Learning Outcome
Mentoring
Module Aim
Module Scope
National
Occupational
Standards
Practical Skill
Programme
Provider
Role
Specialism
Trainer
Theme
Work based learning
Work Performance
Work place
elective or professional practice and can be combined to meet
the needs of specific programmes
A high level, outcome based statement that describes what a
trainee will be able to do at the end of the module
Mentoring is a process in which a trainer (mentor) is
responsible for overseeing the career and development of the
trainee. The emphasis is therefore on the relationship (rather
than the activity).
The overall objective of a work based learning module –
defining the intended learning achievements of the trainee.
The Aim works together with the ‘Scope’ statement to define
the overall objectives and scope of the module
A statement within work based learning modules that defines
the range/limits/ of the learning undertaken by the trainee in a
module – patients/investigations/equipment/modalities etc)
Nationally recognised standards of expected workplace
performance and level of competence for a role. The
standards are outcome-based, defining what the role holder
should to be able to do, as well as what they must know and
understand to demonstrate competent work performance.
National Occupational Standards are supported by nationally
agreed frameworks of expected attitudes, behaviour and skills.
A cognitive, psychomotor, physical or communicative ability
that supports performance of required role.
The package of learning, teaching assessment and quality
assurance leading to an award.
An organisation that delivers required training and learning
activities, to specified quality assurance requirements
A collection of functions undertaken in the workplace that
represent the main broad areas of work for all similar workers
at national level. A role differs from a job, the latter being
defined specifically for a local context.
A focused area of practice within a theme of healthcare
science.
A qualified individual who provides learning and development
support for trainees
A cluster of related specialisms within a division of healthcare
science.
Learning that takes place in a real work setting and involves
the application of academic learning to real work activities
The requirements of satisfactory and consistent demonstration
of competence in specified functions for a work role.
A real work setting in which the trainee can apply learning.
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APPENDIX 2: GOOD SCIENTIFIC PRACTICE
Good Scientific Practice
Section 1: The purpose of this document
There are three key components to the Healthcare Science workforce in the UK:
1. Healthcare Science Associates and Assistants who perform a diverse range
of task based roles with appropriate levels of supervision.
2. Healthcare Science Practitioners have a defined role in delivering and
reporting quality assured investigations and interventions for patients, on
samples or on equipment in a healthcare science specialty, for example
Cardiac Physiology, Blood Sciences or Nuclear Medicine. They also provide
direct patient care and more senior Healthcare Science Practitioners develop
roles in specialist practice and management.
3. Healthcare Scientists are staff that have clinical and specialist expertise in a
specific clinical discipline, underpinned by broader knowledge and experience
within a healthcare science theme. Healthcare scientists undertake complex
scientific and clinical roles, defining and choosing investigative and clinical
options, and making key judgements about complex facts and clinical
situations. Many work directly with patients. They are involved, often in lead
roles, in innovation and improvement, research and development and
education and training. Some pursue explicit joint academic career pathways,
which combined clinical practice and academic activity in research, innovation
and education.
This document sets out the principles and values on which good practice undertaken
by the Healthcare Science workforce is founded.
Good Scientific Practice sets out for the profession and the public the standards of
behaviour and practice that must be achieved and maintained in the delivery of work
activities, the provision of care and personal conduct.
Good Scientific Practice uses as a benchmark the Health Professions Council (HPC)
Standards of Proficiency and Standards of Conduct, Performance and Ethics, but
expresses these within the context of the specialities within Healthcare Science,
recognising that three groups of the workforce, Biomedical Scientists, Clinical
Scientists and Hearing Aid Dispensers are regulated by the HPC. The aim is that the
standards are accessible to the profession and understandable by the public.
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Good Scientific Practice represents standards and values that apply throughout an
individual’s career in healthcare science at any level of practice. The standards will
be contextualised by the role within Healthcare Science that an individual
undertakes. This means that the standards must be interpreted based on the role
that an individual performs. For example, in supervised roles where individuals work
within defined procedures, rather than autonomously, some standards will need to
be interpreted appropriately for the context of the specific role. There will, however,
always be a requirement for an individual to work within the limits of their scope of
practice and competence.
Students and trainees will be expected to be working towards meeting the
expectations set out in this document. However, if an individual is undertaking further
training and development following qualification from a professional training
programme, he or she will be expected to be able to meet the standards in this
document within their scope of practice.
The standards have been used to support curriculum development and will be used
to underpin the process of judging individual equivalence, particularly for emerging
specialisms.
The standards have been divided into five domains. The domains of Good Scientific
Practice detailed in section 2 are:
1.
2.
3.
4.
5.
Professional Practice
Scientific Practice
Clinical Practice
Research and development
Clinical Leadership
Section 2: The domains of Good Scientific Practice
Domain 1: Professional Practice
All patients and service users are entitled to good standards of professional
practice and probity from the Healthcare Science workforce including the
observance of professional codes of conduct and ethics. In maintaining your
fitness to practice as a part of the Healthcare Science workforce, you must:
1.1
Professional Practice
1.1.1 Make the patient your first concern
1.1.2 Exercise your professional duty of care
1.1.3 Work within the agreed scope of practice for lawful, safe and effective
healthcare science
1.1.4 Keep your professional, scientific, technical knowledge and skills up to date
1.1.5 Engage fully in evidence based practice
1.1.6 Draw on appropriate skills and knowledge in order to make professional
judgements
1.1.7 Work within the limits of your personal competence
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1.1.8 Act without delay on concerns raised by patients or carers or if you have
good reason to believe that you or a colleague may be putting people at
risk
1.1.9 Never discriminate unfairly against patients, carers or colleagues
1.1.10 Treat each patient as an individual, respect their dignity and confidentiality
and uphold the rights, values and autonomy of every service user, including
their role in the diagnostic and therapeutic process and in maintaining
health and well-being.
1.1.11 Respond constructively to the outcome of audit, appraisals and
performance reviews, undertaking further training where necessary
1.2
Probity
1.2.1 Make sure that your conduct at all times justifies the trust of patients, carers
and colleagues and maintains the public’s trust in the scientific profession
1.2.2 Inform the appropriate regulatory body without delay if, at any time, you
have accepted a caution, been charged with or found guilty of a criminal
offence, or if any finding has been made against you as a result of fitness
to practice procedures, or if you are suspended from a scientific post, or if
you have any restrictions placed on your scientific, clinical or technical
practice
1.2.3 Be open, honest and act with integrity at all times, including but not limited
to: writing reports, signing documents, providing information about your
qualifications, experience, and position in the scientific community, and
providing written and verbal information to any formal enquiry or litigation,
including that relating to the limits of your scientific knowledge and
experience
1.2.4 Take all reasonable steps to verify information in reports and documents,
including research
1.2.5 Work within the Standards of Conduct, Performance and Ethics set by your
profession
1.3
Working with colleagues
1.3.1 Work with other professionals, support staff, service users, carers and
relatives in the ways that best serve patients’ interests
1.3.2 Work effectively as a member of a multi-disciplinary team
1.3.3 Consult and take advice from colleagues where appropriate
1.3.4 Be readily accessible when you are on duty
1.3.5 Respect the skills and contributions of your colleagues
1.3.6 Participate in regular reviews of team performance.
1.4
Training and developing others
1.4.1 Contribute to the education and training of colleagues
1.4.2 If you have responsibilities for teaching, develop the skills, attitudes and
practices of a competent teacher
1.4.3 Ensure that junior colleagues and students are properly supervised
1.4.4 Support colleagues who have difficulties with performance, conduct or
health
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1.4.5 Share information with colleagues to protect patient safety
1.4.6 Provide work-based development for colleagues to enhance/improve skills
and knowledge
Domain 2: Scientific Practice
As a part of the Healthcare Science workforce, you will keep your scientific and
technical knowledge and skills up to date to effectively:
2.1
Scientific Practice
2.1.1 Develop investigative strategies/procedures/processes that take account of
relevant clinical and other sources of information
2.1.2 Provide scientific advice to ensure the safe and effective delivery of
services
2.1.3 Undertake scientific investigations using qualitative and quantitative
methods to aid the screening, diagnosis, prognosis, monitoring and/or
treatment of health and disorders appropriate to the discipline
2.1.4 Investigate and monitor disease processes and normal states
2.1.5 Provide clear reports using appropriate methods of analysing, summarising
and displaying information
2.1.6 Critically evaluate data, draw conclusions from it , formulate actions and
recommend further investigations where appropriate
2.2
Technical Practice
2.2.1 Provide technical advice to ensure the safe and effective delivery of
services
2.2.2 Plan, take part in and act on the outcome of regular and systematic audit
2.2.3 Work within the principles and practice of instruments, equipment and
methodology used in the relevant scope of practice
2.2.4 Demonstrate practical skills in the essentials of measurement, data
generation and analysis
2.2.5 Assess and evaluate new technologies prior to their routine use
2.2.6 Identify and manage sources of risk in the workplace, including specimens,
raw materials, clinical and special waste, equipment, radiation and
electricity.
2.2.7 Apply principles of good practice in health and safety to all aspects of the
workplace
2.2.8 Apply correct methods of disinfection, sterilisation and decontamination and
deal with waste and spillages correctly.
2.2.9 Demonstrate appropriate level of skill in the use of information and
communications technology
2.3
Quality
2.3.1 Set, maintain and apply quality standards, control and assurance
techniques for interventions across all clinical, scientific and technological
activities
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2.3.2 Make judgements on the effectiveness of processes and procedures
2.3.3 Participate in quality assurance programmes
2.3.4 Maintain an effective audit trail and work towards continuous improvement
Domain 3: Clinical Practice
As a part of the Healthcare Science workforce, you will keep your clinical skills up
to date and undertake the clinical duties appropriate to your role in order to
effectively:
3.1
Clinical Practice
3.1.1 Ensure that you and the staff you supervise understand the need for and
obtain relevant consent before undertaking any investigation, examination,
provision of treatment, or involvement of patients and carers in teaching or
research
3.1.2 Ensure that you and the staff you supervise maintain confidentiality of
patient information and records in line with published guidance
3.1.3 Ensure that you and your staff understand the wider clinical consequences
of decisions made on your actions or advice
3.1.4 Demonstrate expertise in the wider clinical situation that applies to patients
who present in your discipline
3.1.5 Maintain up to date knowledge of the clinical evidence base that underpins
the services that you provide and/or supervise and ensure that these
services are in line with the best clinical evidence
3.1.6 Plan and determine the range of clinical/scientific investigations or products
required to meet diagnostic, therapeutic, rehabilitative or treatment needs
of patients, taking account of the complete clinical picture
3.1.7 Plan and agree investigative strategies and clinical protocols for the optimal
diagnosis, monitoring and therapy of patients with a range of disorders
3.1.8 Ensure that detailed clinical assessments are undertaken and recorded
using appropriate techniques and equipment and that the outcomes of
these investigations are reviewed regularly with users of the service
3.1.9 Ensure the provision of expert interpretation of complex and or specialist
data across your discipline in the context of clinical questions posed
3.1.10 Undertake and record a detailed clinical assessment using appropriate
techniques and equipment
3.1.11 Provide specialised clinical investigation and/or analysis appropriate to your
discipline
3.1.12 Provide interpretation of complex and/or specialist data in the context of the
clinical question posed
3.1.13 Provide clinical advice based on results obtained, including a diagnostic or
therapeutic opinion for further action to be taken by the individual directly
responsible for the care of the patient
3.1.14 Provide expert clinical advice to stakeholders in order to optimise the
efficiency and effectiveness of clinical investigation of individuals and
groups of patients
3.1.15 Prioritise the delivery of investigations, services or treatment based on
clinical need of patients
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3.1.16 Represent your discipline in multidisciplinary clinical meetings to discuss
patient outcomes and the appropriateness of services provided
3.1.17 Ensure that regular and systematic clinical audit is undertaken and be
responsible for modifying services based on audit findings.
3.2
Investigation and reporting
3.2.1 Plan and conduct scientific, technical, diagnostic, monitoring, treatment and
therapeutic procedures with professional skill and ensuring the safety of
patients, the public and staff
3.2.2 Perform investigations and procedures/design products to assist with the
management, diagnosis, treatment, rehabilitation or planning in relation to
the range of patient conditions/equipment within a specialist scope of
practice
3.2.3 Monitor and report on progress of patient conditions/use of technology and
the need for further interventions.
3.2.4 Interpret and report on a range of investigations or procedures associated
with the management of patient conditions/equipment
Domain 4: Research, Development and Innovation
As part of the Healthcare Science workforce, research, development and
innovation are key to your role. It is essential in helping the NHS address the
challenges of the ageing population, chronic disease, health inequalities and rising
public expectations of the NHS. In your role, you will undertake the research,
development and innovation appropriate to your role in order to effectively:
4.1
Research, Development and Innovation
4.1.1 Search and critically appraise scientific literature and other sources of
information
4.1.2 Engage in evidence-based practice, participate in audit procedures and
critically search for, appraise and identify innovative approaches to practice
and delivery of healthcare
4.1.3 Apply a range of research methodologies and initiate and participate in
collaborative research
4.1.4 Manage research and development within a governance framework
4.1.5 Develop, evaluate, validate and verify new scientific, technical, diagnostic,
monitoring, treatment and therapeutic procedures and, where indicated by
the evidence, adapt and embed them in routine practice
4.1.6 Evaluate research and other available evidence to inform own practice in
order to ensure that it remains at the leading edge of innovation.
4.1.7 Interpret data in the prevailing clinical context
4.1.8 Perform experimental work, produce and present results
4.1.9 Present data, research findings and innovative approaches to practice to
peers in appropriate forms
4.1.10 Support the wider healthcare team in the spread and adoption of innovative
technologies and practice
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Domain 5: Clinical Leadership
All patients and service users have a right to expect that Healthcare Science
services efficiently and effectively managed to meet service needs. As a leader in
Healthcare Science, you will seek to effectively:
5.1
Leadership
5.1.1 Maintain responsibility when delegating healthcare activities and provide
support as needed
5.1.2 Respect the skills and contributions of your colleagues
5.1.3 Protect patients from risk or harm presented by another person’s conduct,
performance or health
5.1.4 Treat your colleagues fairly and with respect
5.1.5 Make suitable arrangements to ensure that roles and responsibilities are
covered when you are absent, including handover at sufficient level of
detail to competent colleagues
5.1.6 Ensure that patients, carers and colleagues understand the role and
responsibilities of each member of the team
5.1.7 Ensure that systems are in place through which colleagues can raise
concerns and take steps to act on those concerns if justified
5.1.8 Ensure regular reviews of team performance and take steps to develop and
strengthen the team
5.1.9 Take steps to remedy any deficiencies in team performance
5.1.10 Refer patients to appropriate health professionals
5.1.11 Identify and take appropriate action to meet the development needs of
those for whom you have management, supervision or training
responsibilities
5.1.12 Act as an ambassador for the Healthcare Science community
Good Scientific Practice AHCS V.2 Final
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APPENDIX 3: FURTHER INFORMATION
NHS Networks
An open network to share curricula produced for the Modernising Scientific Careers
programme. Join this network to get updates whenever there is new content.
http://www.networks.nhs.uk/nhs-networks/msc-framework-curricula/
Details of the Scientist Training Programme including MSc Clinical Science
Curricula, Work Based Learning Guides.
http://www.networks.nhs.uk/nhs-networks/msc-framework-curricula/stp
Chief Scientific Officer (CSO), Department of Health
Source of information and news including the CSO Bulletin, latest press releases,
publications and consultations.
http://www.dh.gov.uk/health/category/chief-scientific-officer/
National School of Healthcare Science (NSHCS)
The National School of Healthcare Science is an important part of the new system
for healthcare science training established through Modernising Scientific Careers.
This new system was set up to ensure that patients benefit from the scientific and
technical advances by ensuring that healthcare science staff have the knowledge
and skills to put these advances into practice.
www.nshcs.org.uk
Academy for Healthcare Science (AHCS)
The Academy for Healthcare Science (AHCS) is a UK wide organisation bringing
together a diverse and specialised scientific community working within the National
Health Service (NHS) and other associated organisations (e.g. the Health Protection
Agency, NHS Blood and Transplant), Health and Social Care Northern Ireland
(HSCNI) and the academic and independent healthcare sector.
http://www.academyforhealthcarescience.co.uk/
Health and Care Professions Council (HCPC)
The HPC are a regulator set up to protect the public. They keep a register of health
professionals who meet the HPC standards for their training, professional skills,
behaviour and health.
http://www.hpc-uk.org/
Last Accessed 29th September 2012
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