Institute of Biomedical Science
Specialist Diploma
Reference Portfolio
IBMS Professional Qualifications | www.ibms.org/education-development
Personal Details
Name:
Degree Qualification(s):
Awarding Institution(s):
Date(s) Obtained:
IBMS Membership Number:
R
IBMS Membership Grade:
e
er
ef
HPC Registration Number:
Date of HPC Registration:
Employment Address:
nc
e
Telephone Number:
op
C
Date Specialist Training Commenced:
Name of Training Officer:
y
Confirmation of Completed Training
Date Training Completed
Training Officer‟s Signature
Candidate‟s Signature
Recommendation for Award of Specialist Diploma
Date of External
Assessment
External Assessor‟s
Signature
3rd Edition (September 2011)
External Assessor‟s Name
Training Review
Reviewed by
Date
Comments
CONTENTS
1.
INTRODUCTION .......................................................................................................... 7
2.
CRITERIA FOR USE OF PORTFOLIO ...................................................................... 13
3.
LABORATORY BASED TRAINING............................................................................ 17
4.
EXTERNAL ASSESSMENT PROCEDURE ............................................................... 21
5.
FREQUENTLY ASKED QUESTIONS ........................................................................ 27
6.
GLOSSARY ................................................................................................................ 33
7.
DISCIPLINE SPECIFIC .............................................................................................. 37
The following sections are to be completed as follows:
Individuals who have completed the NHSCSP Certificate of Competence should
complete Section 7A.
Individuals who have completed/are completing the City & Guilds Portfolio for the
Diploma in Cervical Cytology Screening for the NHS Cervical Screening Programmes
should complete Section 7B.
Section 7A .......................................................................................................................... 37
7A.1 Cervical Cytopathology ........................................................................................ 38
7A.1a
Female Genital Tract .................................................................................... 38
7A.1b
Cervical Screening Programmes .................................................................. 40
7A.1c
Aetiology and Epidemiology of Cervical Cancer ........................................... 42
7A.1d
Call and Recall Systems ............................................................................... 44
7A.1e
Liquid Based Cytology .................................................................................. 46
7A.1f
Primary Care................................................................................................. 48
7A.1g
Processing Cervical Samples ....................................................................... 50
7A.1h
Screening of Cervical Samples – Normal Cellular Appearance ................... 52
7A.1i
Screening of Cervical Samples – Organisms ............................................... 54
7A.1j
Screening of Cervical Samples – Abnormalities ........................................... 56
7A.1k
Management of Cytology Reports ................................................................ 58
7A.1l
Quality Assurance and Audit ........................................................................ 60
7A.1m Colposcopy and Gynaecology ...................................................................... 62
7A.1n
Failsafe ......................................................................................................... 64
7A.1o
New Technologies and Ancillary Techniques in Screening .......................... 66
7A.2 Non-cervical Cytopathology ................................................................................. 70
7A.2a
General Non-cervical Cytology ..................................................................... 70
7A.2b
Respiratory Tract .......................................................................................... 72
7A.2c
Urinary Tract ................................................................................................. 74
7A.2d
Serous Cavities............................................................................................. 76
7A.2e
Fine Needle Aspiration Collection and Preparation ...................................... 78
7A.2f
Laboratory Procedures ................................................................................. 80
Section 7B .......................................................................................................................... 85
7B.1 Cervical Cytopathology ........................................................................................ 86
7B.1a
Female Genital Tract .................................................................................... 86
7B.1b
Cervical Screening Programmes .................................................................. 88
7B.1c
Aetiology and Epidemiology of Cervical Cancer ........................................... 90
7B.1d
Quality Assurance and Audit ........................................................................ 92
7B.1e
Diagnosis and treatment of malignancies of the female genital tract. .......... 94
7B.1f
New Technologies and Ancillary Techniques in Screening .......................... 96
7B.1g
Primary Care Processing .............................................................................. 98
7B.2 Non-cervical Cytopathology ............................................................................... 102
7B.2a
General Non-cervical Cytology ................................................................... 102
7B.2b
Respiratory Tract ........................................................................................ 104
7B.2c
Urinary Tract ............................................................................................... 106
7B.2d
Serous Cavities........................................................................................... 108
7B.2e
Fine Needle Aspiration Collection and Preparation .................................... 110
7B.2f
Laboratory Procedures ............................................................................... 112
1. INTRODUCTION
1.
INTRODUCTION
The IBMS has developed the Specialist Portfolio to enable the recognition of structured,
standardised post-registration training and assessment of newly registered biomedical
scientists. The portfolio enables individuals to provide evidence of training, practical skills,
specialist knowledge and competency gained in the two years after registration into the
profession.
Newly registered individuals have the opportunity to evidence their
development of specialist knowledge and competencies in their chosen field by completion
of the Institute‟s Specialist Portfolio. They must, as a minimum requirement, be in the
IBMS membership class of Licentiate.
The training portfolio is issued on application to the Institute with the required payment,
which is inclusive of the end point assessment. Applicants must be working in a laboratory
with Institute post registration training approval. The portfolio is not available to Associate
members of the Institute or individuals undertaking pre-registration training.
Completion of the portfolio and successful assessment will lead to the award of a
discipline specific Specialist Diploma. The Specialist Diploma confers eligibility to apply to
upgrade Institute membership from the class of Licentiate to Member provided the
individual has a minimum of 2 years professional experience as a Licentiate member.
In order to be awarded an Institute Specialist Diploma the individual must be a fully paid
up corporate member of the Institute for at least one year and have completed the
Institute‟s Specialist Training Portfolio in accordance with the Institute‟s instructions.
The portfolio can be used as evidence to help biomedical scientists seeking career
advancement, identifying education and training needs if returning to work or working in
new disciplines, or by employers when considering eligibility for promotion. The portfolio
can also be used by Higher Education Institutions in assessing work-based learning and
accredited learning for postgraduate qualifications.
It is recognised that the changes in service delivery and reconfiguration of pathology
services is leading to combined disciplines or variations in the scope of practice for
individuals within some laboratories. Such is the potential variation that a „one size fits all‟
specialist portfolio in blood sciences is not practical.
A named discipline specific portfolio therefore reflects the range of analyses performed by
most routine laboratories in the UK, although some might not be performed in the
candidate‟s own laboratory. All sections must be completed in order to express the ability
of the biomedical scientist to operate at the specialist level. Where a particular analysis is
not performed in the candidate‟s laboratory, knowledge of the principles and practice must
still be demonstrated, together with an understanding of the key skills required to perform
the test. There may be other tests the training laboratory includes in its basic repertoire
and therefore requires the individual to be competent in. These can be assessed and then
recorded in the reflective log at the end of each sub-section.
7
To support members working in routine service laboratories that reflect a more crossdiscipline requirement for specialist practitioners, provision will be made, following
purchase of the most appropriate discipline-specific portfolio, for modules to be substituted
with one or more modules from specialist portfolios of other disciplines. The Specialist
Diploma award transcript will reflect the main discipline plus altered modules. Requests
from laboratory managers wishing to use the specialist portfolios to reflect the test
repertoire of their laboratory will be considered upon submission of a written proposal of
modules (and rationale for the request) to the Institute‟s Education Department, ahead of
commencement of training.
Achievement of the required knowledge and competence of the range of analyses
expresses the ability of the biomedical scientist to operate at the specialist level as defined
in the learning outcomes below:
Learning Outcomes
The learning outcomes of the Specialist Diploma are subdivided into the following three
areas which candidates must be able to demonstrate they have met through completion of
the portfolio and subsequent assessment procedure.
Knowledge and understanding
a. Demonstrate knowledge of complex scientific and technical aspects of their
specialist discipline including: correct procedures for handling specimens before,
during and after analysis; maintenance of routine equipment; principles of in-house
data management systems and quality control/assurance procedures as evidenced
by in-house assessments and laboratory tour.
b. Show an awareness of current issues and developments within healthcare and
biomedical science as evidenced by presentation and laboratory tour.
c. Demonstrate knowledge of the scientific basis of the laboratory tests and the
disease process under investigation as demonstrated by in house assessments
and tour.
Professional skills
a. Perform a range of laboratory tests without immediate supervision Demonstrate
self-direction in solving problems and exercising personal autonomy in relation to
scope of practice as demonstrated by in-house assessments.
b. Demonstrate a systematic application of professional knowledge and
understanding in interpretation of laboratory data to determine action based on
best practice as evidenced by in house assessments and portfolio evidence.
Transferable skills
a. Demonstrate communication skills within the healthcare environment and as part of
the laboratory team as evidenced by presentation.
b. Demonstrate the ability to critically reflect in order to inform best practice as
evidenced by all aspects of the portfolio.
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During completion of the portfolio, biomedical scientists will be gathering evidence of
continuing professional development (CPD) and competence to practice. This meets the
fundamental requirements of continuing registration with the HPC, i.e. compliance with the
following areas:
Professional autonomy and accountability
Professional relationships
Identification and assessment of health and social care needs
Formulation and delivery of plans and strategies for meeting health and social care
needs
Critical evaluation of the impact of, or response to, the registrant‟s actions
Knowledge, understanding and skills
Internal Assessments
Each of the standards within the discipline specific section requires the candidate to
demonstrate knowledge and competence elements. It is the responsibility of the trainer(s)
to ensure that these elements; a) and b) below have been met through internal
assessments and filed in a single “specialist” portfolio ready for external assessment.
a.
Questions set by trainer
Each standard requires the assessment of competence primarily through the answering of
questions set by the trainer on the stated subject areas indicated by the knowledge and
competence statements for each module. The portfolio is not prescriptive about the type of
assessment which may be done via an oral tutorial, written questions or other suitable
task. (Please note: Essays are NOT considered a suitable form of assessment).
b.
Other evidence
Although evidence of training and assessment may be generated as part of good
laboratory practice only ONE other example of evidence is required for the Evidence of
Achievement section. This is chosen by the candidate as an example of evidence that
demonstrates their knowledge and competence in performing a particular technique. The
choice of evidence is justified in the Reflective log.
Other examples of evidence that may be acquired during the course of training can, if the
candidate wishes, be filed for reference purposes in a separate portfolio as additional
evidence of competence. THIS IS ENTIRELY OPTIONAL AND IS NOT A MANDATORY
PART OF THE EXTERNAL ASSESSMENT PROCESS. This may include the recorded
observation of practical skills, case studies or other evidence of knowledge acquired
during formal study for a postgraduate award or as part of an internal training regime.
9
Reference to „a range of sample types‟ can include blood, serum, plasma, urine, CSF,
other fluids and tissues as appropriate to the routine investigation within the discipline,
either as a main discipline (e.g. Haematology or Clinical Biochemistry) or a combination of
disciplines (e.g. Blood Sciences). It also includes by inference, the knowledge and
competence required to assess the suitability of the sample under investigation, for
example lipaemic, inadequate, haemolysed, inappropriately labelled, transported, or
stored samples within a specific sample type and for analysis using specific equipment.
How to Use This Portfolio
A summary of the criteria for using the Specialist Portfolio is contained in Section 2.
Further information regarding laboratory training is contained in Section 3.
Information about the assessment process is contained in Section 4.
Answers to frequently asked questions can be found in Section 5.
A glossary of commonly used terms is listed in Section 6.
PLEASE NOTE:
Whilst the award of a higher degree is not a prerequisite for the award of a Specialist
Diploma there is the opportunity to integrate the two where possible. For example, inservice training undertaken to complete this portfolio could be recognised by higher
education institutions under the category of work-based learning and accrue academic
credit towards an M level qualification. Equally, the formal education and assessments
undertaken as part of an MSc degree may support in-house laboratory training for
completion of the portfolio.
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2. CRITERIA FOR USE OF
PORTFOLIO
2.
CRITERIA FOR USE OF PORTFOLIO
2.1
Only the Institute‟s Specialist Portfolio can be used for the purpose of recording the
training of a biomedical scientist for the Institute‟s award of a Specialist Diploma.
2.2
Specialist portfolio training must take place in a laboratory approved for training by
the Institute.
2.3
The Specialist Portfolio will only be issued to a named Institute member upon
completion of the application form by the Departmental Training Officer or
Manager.
2.4
The portfolio requires specific evidence that indicates that candidates have applied
knowledge, comprehension and analytical skills gained at undergraduate level to
the (new) situation in which they work as a registered biomedical scientist.
2.5
The portfolio will contain a completed and signed record of laboratory training in the
designated speciality, together with a reflective commentary on the learning
experience and demonstration of competence.
2.6
Each module contains Knowledge and Competency statements that relate to a
laboratory technique or investigative method.
2.7
Requirements for evidence of training and internal assessment of competency are
set out in the Evidence of Achievement section of the portfolio.
2.8
The laboratory training officer (or a suitable deputy) and the individual undertaking
training must sign and date when the training was completed.
2.9
The candidate must complete the Reflective Log to demonstrate that they can
relate knowledge from several areas, draw conclusions and reflect on their own
performance as an independent professional learner, thus meeting the
requirements for CPD.
2.10
A signed statement must be provided by the laboratory manager, which indicates
the laboratory‟s repertoire and analyses that a specialist practitioner working in that
laboratory would be expected to perform without supervision.
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3. LABORATORY BASED
TRAINING
3.
LABORATORY BASED TRAINING
3.1
To permit eligibility for the award of the Institute‟s Specialist Diploma in a named
discipline(s), the in-service training and assessment must demonstrate sufficient
good scientific practice, based on the knowledge and competence in the stated
procedures, to meet the requirements of the external assessment process.
3.2
Suitable training can be obtained only by working in a laboratory approved by the
Institute. Several trainers may be involved and it is essential that all training is coordinated and carried out under the control of a designated training co-ordinator or
training officer.
3.3
A training programme should be prepared and adhered to in accordance with the
Institute‟s Clinical Laboratory Standards for Pre and Post Registration Training of
Biomedical Scientists.
3.4
The training co-ordinator/officer should ensure that regular reports on progress
from trainers are reviewed at least once a month, discussed with the individual
being trained, and documented in the portfolio. The object of these review pages is
to ensure that a constructive, detailed, and contemporaneous record is kept, on
which future training activities can be based.
3.5
Competence must be achieved by coverage of all modules within the chosen
disciplines. Some tests may be considered as „core‟ and require demonstration of
practical competence. If an investigation were considered to be outside the core
repertoire of a routine laboratory, the tests only requires demonstration of
knowledge and understanding that would be applied to the practical situation.
3.6
Short periods of secondment to other Institute approved laboratories may
supplement training in order for the individual to gain additional practical skills and
experience.
3.7
Candidates and trainers may undertake a selection of the following activities to
complete training and assess the application of knowledge and skills, i.e. the
assessment of competence.
3.8
i)
Work-based training with direct observation of practical skills (DOPS);
ii)
Case based discussion to demonstrate knowledge of „output‟ of work;
iii)
Self-directed reading to broaden knowledge;
iv)
Tutorials and scientific discussion to explore extent of knowledge;
v)
Reflective practice to self-assess knowledge and skills;
vi)
Question and answers sessions with trainer to test knowledge.
Evidence from all of the examples above is not required. The ONLY evidence
required for the external assessment process is based on direct observation of
skills and questions set by the trainer to assess working knowledge and the
selected piece of work related to the knowledge and competency statements of
each module as indicated in the Evidence of Achievement section of the portfolio.
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4. EXTERNAL ASSESSMENT
PROCEDURE
4.
EXTERNAL ASSESSMENT PROCEDURE
4.1
On completion of training in accordance with the requirements of the Specialist
Portfolio, the candidate‟s employer (laboratory manager or training officer) should
apply to the Institute for the appointment of a visiting external assessor. The
appointed external assessor will be instructed to contact the laboratory to arrange
a mutually acceptable date and time for the assessment visit. Documentation
guiding the assessment visit will be sent by the Institute to both the assessor and
the training laboratory.
4.2
The aims of the assessment procedure are to:
Independently verify that competence has been met (portfolio) and assess
the standard of the candidate for suitability for the award of a Specialist
Diploma (presentation and laboratory tour);
Ensure consistency between disciplines and between laboratories;
Check that professional body guidelines and criteria are applied nationally;
Reassure the employer that their training is to the appropriate standard;
Disseminate areas of good practice;
Provide constructive feedback on areas of unsatisfactory practice.
4.3
Role of the External Assessor appointed by the Institute
The external assessor for Specialist Portfolios undertakes the dual role of verifier
and assessor/examiner. This individual reviews the portfolio to verify appropriate
training has been given and completed, and then assesses the candidate through
their oral presentation and during the laboratory tour to determine their suitability
for the award of the Specialist Diploma.
It is not the role of the external assessor to assess the competence of the
candidate. This is the responsibility of the trainer, the evidence of which is
exemplified in the portfolio. The Institute‟s role is to verify this has taken place (by
checking the portfolio for evidence of training and assessment of competence) and
also assess the ability of the candidate to demonstrate an understanding of the
scientific basis for tests, quality control, quality assurance, quality management,
health and safety and use of equipment commensurate with the learning outcomes
in the portfolio. The Institute‟s representative will also make an assessment on
whether or not the laboratory is complying with IBMS standards for approval of the
laboratory for training.
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4.4
The following process enables the Institute to award a Specialist Diploma to
individuals that meet the criteria and also award a certificate to show “Approved
Training Laboratory” status.
Stage 1: Presentation (Indicative time 15-20 mins)
The presentation is to ensure that candidates can demonstrate an understanding
of their scope of practice and role in the laboratory. The presentation must be in
PowerPoint format. If projection facilities are not available it can be viewed on a
computer screen. It is expected that the 15-20 minute presentation will contain the
following elements:
An indication of the candidate‟s scope of practice and how it has developed
since registration based on the reflective practice elements of the portfolio;
Current developments in the laboratory or recent trends;
Special interests or professional activities of the individual.
Presentations need not be overcomplicated, should be structured to reflect the
areas in which experience has been gained and act as a prompt for the dialogue,
which supports the work done in the specialist portfolio.
The candidate‟s presentation skills are not being tested so notes are acceptable
but not encouraged. They should only be used to support the PowerPoint
presentation slides.
The external assessor may wish to ask some questions related to the presentation
or seek points of clarification.
Stage 2: Portfolio Assessment (Indicative time 60 mins)
Assessors should aim to review the portfolio in one hour, which is sufficient to look
at evidence contained in a single lever arch file. More evidence than this is
deemed as excessive although assessors should not use this as a sole reason to
fail to the candidate. It is acceptable for the external assessor to check with the
laboratory before the visit that evidence is limited to one file, and if not, request that
it is.
There should be a signed statement from the laboratory manager testifying to the
range of laboratory investigations undertaken by the candidate. (see Section 2:
Use of the Portfolio, paragraph 2.5). This can be used by the external assessor to
guide the areas for questioning during the laboratory tour. It is acceptable for
external assessors to request this prior to the visit when they finalise arrangements
with the laboratory.
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Evidence in the portfolio is prescribed in the EVIDENCE OF ACHIEVEMENT
section and this is the ONLY evidence that is required. Evidence should be
indexed in the same order as the Specialist Portfolio modules. Additional (optional)
supporting evidence of training may be provided in a separate portfolio and
referred to if required.
The Evidence of Achievement section has three standard requirements:
observed by trainer to carry out a specific function/investigation (signature as
evidence);
answered questions set by trainer (single piece of evidence to demonstrate
this);
single piece of evidence chosen by candidate (not the trainer) to reflect an
aspect of the training.
The signed assessment of practice does not require a separate witness
statement (unlike the Registration Portfolio).
“Questions asked by the trainer” are informed by the knowledge component and
competence requirements of each module. Evidence should support the fact that
candidates understand their role and are competent to perform the work, either
through questions they have been asked, set (and marked) questions or notes
from tutorials. Evidence must be dated and signed by the candidate/training officer
as appropriate.
The third piece of evidence is selected by the candidate and chosen to
demonstrate an aspect of the training and competency assessment. This choice is
briefly justified in the Reflective Log, (e.g. as my third piece of evidence I chose to
annotate a laboratory printout of results from a test I performed because…).
Following the EVIDENCE OF ACHIEVEMENT section the Institute‟s portfolios
must be signed by the internal person who has checked that the requirements for
evidence for the module have been completed.
The reflective logs are intended to demonstrate that the candidate has developed
in the application of their practice and can apply what they have learned in the
context of the module. The external assessor will review these reflective reports
which should be supported by the evidence contained in the portfolio. This may
lead to further discussion on the laboratory tour.
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Stage 3: Laboratory Tour (Maximum 60 mins)
The tour should not exceed 60 mins which is considered to be sufficient time to
examine the candidate‟s knowledge, even in a large department. The candidate
should be able to respond to questions asked by the external assessor based on
the knowledge components of the portfolio and their scope of practice. The
candidate should be able to demonstrate they have knowledge of the underlying
principles and practice of laboratory investigations they have performed and the
equipment they use. If the candidate is involved in training it is reasonable to
expect them to explain how they do this. They should be able to explain NEQAS
results, and demonstrate that they know how to apply health and safety. In doing
so they demonstrate (in conjunction with their presentation and portfolio of
evidence) that they meet the learning outcomes detailed in the introductory section
of the portfolio.
Stage 4: Approval of laboratory for Specialist Training
The Institute has published guidance and criteria for approval of laboratories for
pre and post registration training. Based on these criteria the laboratory tour also
gives the external assessor an opportunity to judge that the laboratory has the
appropriate requirements for training against the following checklist. This is
provided as separate documentation and is available on the Institute‟s website.
Stage 5: Feedback Comments to Trainer and Candidates.
At the end of the assessment process the external assessor informs the candidate
and training officer whether they will be making a recommendation (in their report
to the IBMS) that the candidate was successful or unsuccessful, and whether or
not a recommendation will be made regarding continued approval of the laboratory
for training. This also provides an opportunity to seek further clarification on points
of evidence if required.
Feedback should be concise, constructive and based on the Institute‟s guidance
for assessors, trainers and candidates in relation to specialist portfolio training and
completion. Personal opinions or advice may be offered in the context of examples
of good practice, but it should be clear they are NOT a specific requirement of the
Institute.
Stage 6: Completion of Reports
Both the external assessor and the laboratory trainer are required to submit reports
to the Institute and send a copy to each other. This provides an opportunity to
share the feedback, and reflect on this.
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5. FREQUENTLY ASKED
QUESTIONS
5.
FREQUENTLY ASKED QUESTIONS
Eligibility
I am not a member of the Institute. Can I complete the specialist portfolio?
No. A candidate must have current corporate membership of the Institute of Biomedical
Science. Corporate classes are Licentiate, Member, or Fellow. Associate members are
not eligible.
Why do I need to complete the specialist portfolio?
Holding a Specialist Diploma is part of the criteria for upgrading your class of Institute
membership from Licentiate to Member. It also demonstrates that you have been
assessed against a benchmark standard for a specialist practitioner in your chosen
discipline. It is therefore different from the registration portfolio required for HPC
registration which is used to evidence that an individual has met a threshold standard of
fitness to practise which is profession-specific, rather than based solely on a single
discipline.
The charge by the Institute for the specialist portfolio is £125. Who should pay?
This is a local decision. Both the employer and individual benefit from the opportunity
provided by the professional body to facilitate, evidence, and formally recognise the
acquisition of specialist skills and knowledge. The charge is a nominal one-off amount
towards providing this service to Institute members, and will also cover external assessor
expenses for the endpoint assessment.
When can my portfolio be assessed?
You are required to be a corporate member of the Institute for a minimum of one year
before a specialist portfolio can be externally assessed by the Institute.
How long will it take for a date to be set for my assessment?
This is dependent on the availability of an external assessor. It could be up to two months
from receipt of your application form. Please apply well in advance of your preferred date
in order for the Institute to organise an external assessor.
Portfolio Organisation and Evidence
When I completed the registration portfolio I was required to have one file of
evidence. Must I approach the specialist portfolio in a similar way? Does it involve
as much work or do I simply fill in the portfolio?
The principles applied to the registration portfolio also apply to the specialist portfolio.
Evidence required for both should not exceed one lever-arch file. Much information has
been published in The Biomedical Scientist and in sections of this portfolio.
Can you provide advice on how to present, organise and complete the specialist
portfolio?
There should be an index and the evidence should be organised to match the sections of
the portfolio.
27
What evidence do I need?
The type of evidence is indicated by the Evidence of Achievement section, and this is the
ONLY evidence required. It must of course be relevant to the knowledge and competence
statements.
In order to sign off some of the sections it says "answered questions set by
trainer..." (on a particular subject). Does this mean that there is no point getting
other evidence for this, and that the only evidence required are some questions I
have answered? Also I have several pieces of evidence for some sections but
haven't yet been given any questions to answer from my trainer, so I’m guessing
this section cannot be signed off until I’ve done them?
The requirements for the evidence of achievement sections are clearly stated. All of them
have "questions set by trainer". It is essential that your trainer conducts an assessment
exercise that tests your knowledge as applied to the particular techniques - this is the
purpose of the "questions asked by trainer". Once completed and you have evidence of
this the trainer can sign off this part of the portfolio.
Can I use evidence from a laboratory I worked in before I started my SP? I used to
work in a reference lab and have copies of published papers with my name on
which cover techniques in the SP but not done in my current laboratory. Obviously
my trainer couldn't sign to say they'd witnessed my practical skills, but would that
be ok to cover the principles?
The requirements for the evidence of achievement sections are clearly stated and do not
include copies of published papers. (You could put these in your professional portfolio).
Who signs?
The Evidence of Achievement section requires the trainers name and signature,
and therefore should be signed by the person who assesses competence at the end of the
relevant training. Underneath is an area in which to confirm the section has been
completed and the evidence assessed and checked internally (e.g. by the training officer).
In some instances this will be the same person.
Is the person who signs the person who actually trained you in that technique, or
does it have to be the training officer? Is it okay for a BMS1 to sign (if they did the
training) or does it have to be a more senior person? I have a very "reluctant"
training officer!
Someone in the laboratory who has assessed your competence should provide the
signature for the portfolio. As long as they are competent to train and assess you, the
grade of staff should not be an issue. However, the training officer (or someone senior)
should take responsibility for assessing the evidence is appropriate for each section and
sign the section underneath the Evidence of Achievement section.
You may wish to discuss these points with your trainer and perhaps with them also review
the guidance on the IBMS website. It may also be helpful to clarify the role of your training
officer with your line manager if they are "reluctant" as this may affect the training status of
the laboratory if there is inappropriate support for training.
28
How do I complete the Reflective Logs at the end of each section?
The aim of this part of the portfolio is to encourage you to think about your experience and
how you can apply your skills in other areas. Try to capture what the laboratory does in
relation to the topic, what you have learned, and how you apply this in the context of
patient diagnosis. Future learning is identified by how you wish to build on this experience.
It is very much an expression of your personal experience.
Training and Standards
I have been working as a trainee biomedical scientist, then as a BMS1 for almost
two years in a specialist laboratory (four years in total), but only applied for my
specialist diploma book after changing my job and starting an MSc. Should the date
of my specialist training be when I became registered with the Health Professions
Council (HPC) or when I received my book?
It is normal for a newly registered practitioner to commence a period of specialist training
in order to consolidate and extend their skills and knowledge in their specialist discipline.
Therefore you may have accumulated evidence suitable for your portfolio in advance of
receiving it.
Can I use anything I sent for assessment for my MSc, as I completed this while
HPC-registered for the past two years?
It may support you training but evidence should be specific to your training and
assessment in the laboratory.
Do I need to complete all sections of the portfolio?
Yes. However, not all sections require evidence of practical competence (it may state „Be
able to describe...'). Similarly, some skills may be transferable such that, together with
knowledge, competence in some techniques may be considered to be achievable, even if
the laboratory does not perform the method routinely.
How long does training take?
Although training can be expected to take up to two years after registration, it may be
possible to complete the portfolio in less time if an individual has previous relevant
experience to build upon for their specialist training (e.g. experienced gained in a single
discipline while on a 12-month university placement).
As a training officer I have just received a specialist portfolio for a member of staff.
How best should I proceed?
There can be no substitute for careful reading of the introductory sections of the portfolios,
relevant articles in The Biomedical Scientist and the Education and Careers/Specialist
Portfolios section of the IBMS website. You may also wish to contact training officers in
other departments to share ideas and good practice so that you fully understand what is
required. It is important that you develop a training programme. This can be based on the
old 'logbook', but should, of course, be geared to the specialist portfolio. The crux of the
qualification is the ability of the individual to articulate knowledge relevant to their specialist
practice (e.g. training junior staff).
29
The portfolio says: "Answered questions set by the trainer". What questions do I
set?
Questions must relate to the knowledge and competence sections and are informed by
your own professional „working‟ knowledge of the principles and application of the
techniques. The level of knowledge should reflect that required of a specialist practitioner
(see Learning Outcomes in the introductory section). Questions may be verbal during a
tutorial session (if so, keep a record of them), written short questions and answers or
multiple-choice exercises. The format is at the discretion of the individual trainer and will
depend on local circumstances.
Are there any courses available to support completion of the specialist portfolio?
No specific courses are run by the IBMS, although you may wish to contact your local
IBMS branch or university to see if anything is available or can be arranged. Some
universities have developed MSc courses with work-based modules linked to the specialist
portfolio.
Do I need to complete my training in one laboratory?
No. There is no requirement to complete in one laboratory and in some cases it may be
desirable to have a secondment to another laboratory for some modules. However, the
laboratory must be approved by the Institute for training.
Specialist Practitioner Status
Do I need the specialist diploma to advance my career?
Although the Institute's qualifications are not mandatory for professional advancement,
they do provide a mechanism by which the employer can measure someone's
competence to practise at a higher level.
When can I do on-call?
When your employer (and yourself) believes you are competent. Ability to do on-call is
defined by the employer and depends on the scope of practice required to perform an outof-hours laboratory service competently to the required standard. As with the registration
portfolio, the specialist diploma in not linked explicitly to on-call (although it might link to
certain elements).
I am changing disciplines. Do I need to undertake a second specialist portfolio?
Not necessarily. There is no requirement to complete a second specialist portfolio;
however, there is a requirement under HPC regulation to be competent in one‟s scope of
practice, and the specialist portfolio is one way you can gain this competence and
evidence it. This could also be guided by the requirements of the knowledge and skills
framework (KSF).
I work in a Blood Sciences department. Which Specialist Portfolio should I apply
for?
Your laboratory manager must apply on your behalf for the most appropriate disciplinespecific portfolio that represents the bulk of your scope of practice (i.e. test repertoire).
Modules can be substituted with one or more modules from specialist portfolios of other
disciplines. The Specialist Diploma award transcript will reflect the main discipline plus
altered modules.
30
6. GLOSSARY
6.
GLOSSARY
The following terminology is used throughout the portfolio.
BE AWARE OF
A general appreciation of the content of the key task.
KNOW
A working knowledge (can describe) of the facts
associated with the key task.
UNDERSTAND
Thorough comprehension (can explain) of the principles
and concepts of the content of the key task.
COMPETENT
Has the ability to perform a test, procedure or area of
practice to a set standard on more than one occasion, in a
consistent manner and with minimal or no supervision,
together with a thorough comprehension of the principles
and concepts of the content of the key task.
The Institute‟s Specialist Diploma will only be awarded if
there is supporting evidence (as indicated in the portfolio‟s
Evidence of Achievement section) that competence has
been achieved. This evidence will be presented as a
portfolio, logically and cross-referenced to the relevant
module or sections it supports.
Suggested examples of evidence:
Audit trail results
EVIDENCE OF
ACHIEVEMENT
Annotated photomicrographs
Annotated copies of QC/EQA records
Tutorial notes for question and answer sessions
PowerPoint presentations by the candidate
Training records
Witness testimonies
Assessment logs (must clearly indicated level of
knowledge and skill achieved)
33
CPA
Clinical Pathology Accreditation
HPC
Health Professions Council
SOP
Standard Operating Procedure.
SoP
Health Professions Council Standards of Proficiency.
34
7. DISCIPLINE SPECIFIC
7.
DISCIPLINE SPECIFIC
Section 7A
This section covers the range of tests appropriate to specialist practice in Cytopathology
and therefore reflects the range of analyses performed by most routine laboratories in the
UK, although some might not be performed in the candidate‟s own laboratory. Completion
of the NHS Cervical Screening Programme training logbook is considered to be an integral
contribution to the award of a Specialist Diploma for this portfolio.
All sections must be completed in order to express the ability of the biomedical scientist to
operate at the specialist level. Where a particular analysis is not performed in the
candidate‟s laboratory knowledge of the principles and practice must still be demonstrated,
together with an understanding of the key skills required to perform the test.
There may be other tests the training laboratory includes in its basic repertoire and
therefore requires the individual to be competent in. These can be assessed and then
recorded in the reflective log at the end of each sub-section.
To support members working in routine service laboratories that reflect a more
cross-discipline requirement for specialist practitioners, provision will be made for
modules to be substituted with one or more modules from specialist portfolios of
other disciplines, e.g. Cellular Pathology.
The Specialist Diploma award transcript will reflect the main discipline plus altered
modules. Requests from laboratory managers wishing to use the specialist
portfolios to reflect the test repertoire of their laboratory will be considered upon a
written submission of proposed modules (and rationale for the request) to the
Institute’s Education Department ahead of commencement of the training.
37
7A.1 Cervical Cytopathology
7A.1a Female Genital Tract
Be able to describe the anatomy, physiology and histology of the female genital tract.
KNOWLEDGE
Understand the anatomy of the female genital tract.
Understand the physiology of the female genital tract.
Understand the histology of the female genital tract.
Understand the process of squamous metaplasia and the development of the
transformation zone.
COMPETENCE
You must be able to:
Describe the various stages of the menstrual cycle, the hormonal variations and the
effects on the epithelia of the female genital tract.
Recognise the cytological and histological features of squamous metaplasia.
Recognise histological images from the female genital tract.
38
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
39
7A.1b Cervical Screening Programmes
Be able to describe the rationale for cervical screening programmes.
KNOWLEDGE
Understand the theory and practice of screening programmes.
Understand the multidisciplinary nature of a cervical screening programme.
Understand the purpose, aims and organisation of the cervical screening programme
appropriate to your country of work.
Be aware of the cervical screening programmes of the other UK countries.
Understand the role cytology plays in a national screening programme.
COMPETENCE
You must be able to:
Access and interpret information relating to a cervical screening programme (KC 53,
KC61, KC65 data or equivalent).
Locate relevant documentation pertaining to the screening programme in the
laboratory (NHS CSP guidelines or equivalent).
40
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
41
7A.1c Aetiology and Epidemiology of Cervical Cancer
Be able to analyse data related to the incidence and prevalence of cervical cancer.
KNOWLEDGE
Understand the incidence, prevalence and world wide variation of cervical cancer.
Understand the risk factors for cervical cancer.
Understand the relationship between human papilloma virus and cervical neoplasia.
COMPETENCE
You must be able to:
Analyse data on incidence and mortality from national statistics.
Relate risk factors to the development of cervical cancer.
42
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
43
7A.1d Call and Recall Systems
Be able to use call and recall systems in accordance with laboratory procedures.
KNOWLEDGE
Understand the systematic nature of cervical screening.
Understand the operation of call and recall systems.
Understand the role of National Programme for information Technology (NpfIT).
Understand the rationales for the age range and intervals for cervical screening.
COMPETENCE
You must be able to:
Assess the appropriateness of a sample received based on call and recall history.
Resolve issues relating to inappropriate recall period.
44
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
45
7A.1e Liquid Based Cytology
Be able to prepare and examine liquid based cytology samples.
KNOWLEDGE
Understand the theory and practice of liquid based cytology.
Understand the similarities and differences between conventional and liquid based
cytology.
Understand how any new liquid based systems are evaluated.
COMPETENCE
You must be able to:
Prepare liquid based cytology samples in accordance with standard laboratory
procedures.
Examine liquid based cytology preparations in accordance with standard laboratory
procedures.
Critically evaluate results.
Complete all relevant documentation in accordance with laboratory quality assurance
and audit requirements.
46
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
47
7A.1f Primary Care
Be able to advise primary care staff on the laboratory requirements for obtaining the
correct sample, matching and transporting these samples.
KNOWLEDGE
Understand the role of primary care staff in obtaining samples for cervical screening.
Understand the principle of audit of sample takers.
Understand how transformation zone sampling is assessed.
COMPETENCE
You must be able to:
Liaise with and advise primary care staff on issues related to sampling.
Identify, refer or return mismatching or incomplete samples to smear takers.
Audit samples taken within a primary care service.
48
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
49
7A.1g Processing Cervical Samples
Be able to process cervical samples.
KNOWLEDGE
Understand the theory and practice of processing cervical samples.
Understand the importance
interpretation of the sample.
of
how
processing
affects
the
microscopical
Understand the theory and practice of fixation.
Understand the theory and practice of Papanicolaou staining.
Know the risk and hazards associated with sample processing.
Understand the principles and application of light microscopy.
COMPETENCE
You must be able to:
Prepare samples in accordance with standard operating procedures.
Identify factors that might influence effective preparation of samples.
Identify risks and hazards when handling and preparing samples.
Prepare liquid based samples for staining in accordance with standard laboratory
procedures.
Stain pre-prepared slides or samples prepared in the laboratory.
Evaluate the stained preparations.
Complete all relevant documentation in accordance with laboratory quality assurance
and audit requirements.
50
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
51
7A.1h Screening of Cervical Samples – Normal Cellular Appearance
Be able to recognise unsatisfactory cervical samples and recognise, normal cells, reactive
and artefactual changes within these samples.
KNOWLEDGE
Understand what constitutes a satisfactory cervical sample and how this may be
distinguished from an unsatisfactory sample.
Understand the normal cellular appearance of cervical sample.
Understand the variations in cellular appearance due to inflammation, metaplasia
and iatrogensis.
Know the relevant internal and external quality assurance procedures.
COMPETENCE
You must be able to:
Identify unsatisfactory samples.
Perform a match between prepared slide and request form.
Microscopically examine prepared slides.
Recognise the normal constituents of a cervical sample including epithelial and nonepithelial cells.
Recognise cellular appearances associated with inflammation, squamous metaplasia
and iatrogenic changes.
Complete all relevant documentation (paper or electronic) in accordance with quality
assurance and audit requirements.
52
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
53
7A.1i Screening of Cervical Samples – Organisms
*
KNOWLEDGE
Understand the role organisms have in the development of vaginitis and cervicitis.
Know the commonly found organisms of the vagina that are seen in cervical
samples.
Be aware of other endogenous and exogenous flora of vagina.
Know the relevant internal and external quality assurance procedures.
COMPETENCE
You must be able to:
Perform a match between prepared slide and request form.
Microscopically examine prepared slides.
Recognise common organisms found in cervical samples.
Recognise the cytopathic effects associated with the presence of organisms or
infections.
Complete all the relevant documentations (paper or electronic) in accordance with
quality assurance and audit requirements.
54
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
55
7A.1j Screening of Cervical Samples – Abnormalities
Be able to recognise and grade squamous, endocervical and non-cervical abnormalities
seen in cervical samples.
KNOWLEDGE
Understand the histopathological basis of cervical intraepithelial neoplasia (CIN) and
squamous carcinoma.
Understand the histopathological basis of cervical glandular intraepithelial neoplasia
(CGIN) and adenocarcinoma.
Understand the cytomorphology of CIN and squamous carcinoma.
Understand the cytomorphology of CGIN and adenocarcioma.
Understand the grading criteria associated with dyskaryosis and CIN.
Understand the relevance of borderline changes.
Understand the histopathological basis of non-cervical adenocarcinoma.
Know the relevant internal and external quality assurance procedures.
COMPETENCE
You must be able to:
Perform a match between prepared slide and request form.
Microscopically examine prepared slides.
Recognise and grade squamous abnormalities.
Recognise and grade glandular abnormalities (cervical and non-cervical).
Recognise cytological features of malignancy.
Recognise the different types of borderline nuclear changes.
Complete all the relevant documentation (paper or electronic) in accordance with
quality assurance and audit requirements.
56
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
57
7A.1k Management of Cytology Reports
Be able to relate results of screen to past history, current investigation or treatment
process and follow-up of treated disease or previous abnormal results.
KNOWLEDGE
Understand the current terminology and guidelines in cervical screening.
Understand the role repeat cervical samples have in monitoring cervical
abnormalities.
Understand the role colposcopy has in diagnosis, assessment and follow-up of
cervical abnormalities.
Understand the role of the gynaecologist in diagnosis and follow-up of non-cervical
abnormalities.
Know the relevant internal and external quality assurance procedures.
COMPETENCE
You must be able to:
Make the correct management recommendations for unsatisfactory or normal
cervical cytology reports.
Describe and record the correct management recommendations for equivocal or
abnormal cervical cytology reports.
Complete all the relevant documentation (paper or electronic) in accordance with
quality assurance and audit requirements.
58
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
59
7A.1l Quality Assurance and Audit
Be able to monitor your personal and your laboratory‟s performance relating results to
histology samples.
KNOWLEDGE
Understand the audit cycle.
Understand the principle of multidisciplinary audit.
Understand the quality assurance structure for the NHSCSP or equivalent.
Understand the importance of internal quality control as part of good laboratory
practice.
Understand the importance of external quality assessment as part of good laboratory
practice.
Understand how quality assurance data are used to help monitor the effectiveness of
the NHSCSP or equivalent.
COMPETENCE
You must be able to:
Interpret quality assurance data to analyse your own performance.
Identify performance out with national performance indicators.
Interpret quality assurance data to analyse your laboratory‟s performance.
60
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
61
7A.1m Colposcopy and Gynaecology
Be able to understand the relationship between diagnosis, treatment and management of
abnormalities.
KNOWLEDGE
Understand the role of colposcopy in the diagnosis, treatment and management of
cervical disease.
Understand the role of the gynaecologist in the diagnosis, treatment and
management of non-cervical disease.
Understand the role of multidisciplinary team meetings in the management of
cervical disease.
COMPETENCE
You must be able to:
Describe the role of colposcopy in the diagnosis, treatment and management of
cervical disease.
Provide information for multidisciplinary team meeting as required.
62
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
63
7A.1n Failsafe
Be able to monitor the referral process resulting from abnormal reports.
KNOWLEDGE
Understand the role of failsafe in the screening programme.
Understand the requirements for laboratory involvement in failsafe programme.
COMPETENCE
You must be able to:
Describe the failsafe system within your laboratory.
64
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
65
7A.1o New Technologies and Ancillary Techniques in Screening
Be able to describe how future developments may impact on cervical screening.
KNOWLEDGE
Understand the use of semi-automated and automated scanning devices.
Understand the technology and use of molecular biological techniques.
Understand the role of HPV testing within the cervical screening programme.
Understand the potential for HPV vaccination.
COMPETENCE
You must be able to:
Describe the potential use of new technologies and how these may be introduced
into the NHS CSP or equivalent.
66
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
67
Reflective Log
This section is used to demonstrate you can relate knowledge from several areas, draw
conclusions and reflect on your own performance as an independent professional learner,
thus meeting the requirements for CPD. It is therefore a useful source of information for
your CPD profile should you be audited by the HPC.
The external assessor will review these reflective reports which should cross reference to
the evidence contained in the portfolio. This may lead to further discussion on the
laboratory tour.
Period of Training:
Summarise the laboratory role in the previous section(s):
Personal reflection on training and example of evidence:
7A.2 Non-cervical Cytopathology
7A.2a General Non-cervical Cytology
Be able to prepare and stain slides from non-cervical cytology samples.
KNOWLEDGE
Know the different types of sampling methods available.
Understand the importance of correct sampling.
Know the correct presentation and requirements for all types of non-cervical sample.
Understand how to prepare all types of non-cervical samples using a variety of
concentration methods, air drying or fixing as appropriate.
Understand how to prepare all types of non-cervical samples using routine staining
methods, specialised staining methods, and ancillary methods.
Understand the risks and hazards associated with fixed and unfixed samples
Understand the ethical and safe use, storage and disposal of residual samples and
stained preparations.
COMPETENCE
You must be able to:
Construct an accurate macroscopic description for all samples.
Optimally prepare all types of non-cervical sample in accordance with standard
operating procedures.
Identify and rectify any problems encountered in specimen preparation.
Stain non-cervical preparations using routine stains, special stains or immunological
methods.
Complete all the relevant documentation (paper or electronic) in accordance with
quality assurance and audit requirements.
70
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
71
7A.2b Respiratory Tract
Be able to prepare, stain and evaluate cytology samples from the respiratory tract.
KNOWLEDGE
Understand the anatomy, physiology and histology of the respiratory tract.
Understand the disease processes affecting the respiratory tract.
Understand investigative methods used in respiratory tract disease.
Understand the relevance and importance of optimising preparatory techniques in
samples from respiratory tract cytology.
Understand the criteria for accessing the adequacy of samples.
Know the normal cytological features of sputum, bronchial washings, brushings and
lavages.
Know the cytological features of contaminants and artefacts including those related
to treatment of disease.
Know the cytological features and cytopathic effects of respiratory tract infections
including:
o
Aspergillus;
o
Candida;
o
Cytomegalovirus;
o
Pneumocystis carinii.
Be aware of the role of cytology in non-neoplastic pulmonary disease.
Know the cytological features and cytopathic effects of malignancy.
Know the cytological appearances of the following tumours:
o
Squamous carcinoma;
o
Small cell anaplastic carcinoma;
o
Adenocarcioma.
Be aware of diagnostic pitfalls.
COMPETENCE
You must be able to:
Work in accordance with standard operating procedures to optimise specimen
preparation utilising the range of techniques available.
Recognise common artefacts, contaminants and infective agents.
Recognise the difference between normal, reactive and malignant cells.
Complete all the relevant documentation (paper or electronic) in accordance with
quality assurance and audit requirements.
72
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
73
7A.2c Urinary Tract
Be able to prepare, stain and evaluate cytology samples from the urinary tract.
KNOWLEDGE
Understand the anatomy, histology and pathophysiology of the urinary tract.
Understand investigative methods used in diagnosing urinary tract disease.
Understand the principal behind industrial screening.
Understand the methods of sample collection.
Understand the relevance and importance of optimising preparatory techniques in
samples from urinary tract cytology.
Know the appearance of contaminants and artefacts.
Know the normal cytological features of urine samples.
Know the appearance and significance of the presence of crystals and casts in urine.
Know the appearance and/or cytopathic effects of urinary tract infections.
Understand iatrogenic changes in urinary tract.
Understand the cytomorphological features of neoplastic disease and malignancy.
Be aware of the grading criteria of papillary carcinoma.
Be aware of diagnostic pitfalls.
COMPETENCE
You must be able to:
Work in accordance with standard operating procedures to optimise specimen
preparation.
Recognise common artefacts, contaminants and infective agents.
Recognise the difference between normal, reactive and malignant cells.
Complete all the relevant documentation (paper or electronic) in accordance with
quality assurance and audit requirements.
74
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
75
7A.2d Serous Cavities
Be able to prepare, stain and evaluate serous fluids peritoneal washings and cytology
samples from serous cavities.
KNOWLEDGE
Know the anatomy, histology and pathophysiology of body cavities.
Know the methods for collection and preparation of serous effusions.
Understand the relevance and importance of optimising preparatory techniques in
samples from serous cavities.
Be aware of the process and significance of serous effusion formation and
associated clinical conditions.
Know the normal cytological features of effusions.
Know and can recognise the cytological features associated with reactive changes in
serous effusions.
Understand the cytomorphological features of malignancy.
Know how to recognise the cytological features of metastatic disease in serous
effusions.
Know how to recognise the significant features associated with malignant
mesothelioma and methods of confirmation.
Understand differential diagnoses and potential diagnostic pitfalls.
COMPETENCE
You must be able to:
Work in accordance with standard operating procedures to optimise specimen
preparation.
Recognise the difference between normal, reactive and malignant cells.
Complete all the relevant documentation (paper or electronic) in accordance with
quality assurance and audit requirements.
76
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
77
7A.2e Fine Needle Aspiration Collection and Preparation
Be able to prepare, stain and evaluate samples when attending fine needle aspirations.
KNOWLEDGE
Understand the theory of fine needle aspiration techniques in superficial sites and
utilising imaging techniques.
Understand procedures available to optimise sample preparation.
COMPETENCE
You must be able to:
Optimise specimen preparation.
Stain slides in accordance with standard operating procedures and critically evaluate
results.
Complete all the relevant documentation (paper or electronic) in accordance with
quality assurance and audit requirements.
78
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
79
7A.2f Laboratory Procedures
Be able to evaluate immediately prepared non-cervical cytology samples.
KNOWLEDGE
Understand the relationship between cell structure and function.
Know the normal cytological features of abraded, aspirated and exfoliated material
from tissues or epithelia.
Know the general cytological features of reactive and malignant cells.
Understand how to correlate cytological features with histology.
Understand the relevance of immediate diagnosis.
Be aware of the current government recommendation on cancer waiting times.
COMPETENCE
You must be able to:
Set up and use a microscope.
Recognise normal cells from a variety of non-cervical samples.
Stain and assess immediately made cytology preparations, either in the laboratory or
at a remote location.
Complete all the relevant documentation (paper or electronic) in accordance with
quality assurance and audit requirements.
80
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
81
Reflective Log
This section is used to demonstrate you can relate knowledge from several areas, draw
conclusions and reflect on your own performance as an independent professional learner,
thus meeting the requirements for CPD. It is therefore a useful source of information for
your CPD profile should you be audited by the HPC.
The external assessor will review these reflective reports which should cross reference to
the evidence contained in the portfolio. This may lead to further discussion on the
laboratory tour.
Period of Training:
Summarise the laboratory role in the previous section(s):
Personal reflection on training and example of evidence:
Section 7B
This section covers the range of tests appropriate to specialist practice in Cytopathology
and therefore reflects the range of analyses performed by most routine laboratories in the
UK, although some might not be performed in the candidate‟s own laboratory. Completion
of the City and Guilds portfolio for the Diploma in Cervical Cytology Screening is a
mandatory requirement for the NHS Cervical Screening Programme and is considered to
be an integral part of the award of a Specialist Diploma for this portfolio.
All sections must be completed in order to express the ability of the biomedical scientist to
operate at the specialist level. Where a particular analysis is not performed in the
candidate‟s laboratory knowledge of the principles and practice must still be demonstrated,
together with an understanding of the key skills required to perform the test.
There may be other tests the training laboratory includes in its basic repertoire and
therefore requires the individual to be competent in. These can be assessed and then
recorded in the reflective log at the end of each sub-section.
To support members working in routine service laboratories that reflect a more
cross-discipline requirement for specialist practitioners, provision will be made for
modules to be substituted with one or more modules from specialist portfolios of
other disciplines, e.g. Cellular Pathology.
The Specialist Diploma award transcript will reflect the main discipline plus altered
modules. Requests from laboratory managers wishing to use the specialist
portfolios to reflect the test repertoire of their laboratory will be considered upon a
written submission of proposed modules (and rationale for the request) to the
Institute’s Education Department ahead of commencement of the training.
85
7B.1 Cervical Cytopathology
7B.1a Female Genital Tract
Be able to describe the anatomy, physiology and histology of the female genital tract,
specifically in relation to precursor lesions and malignancy, and to be able to relate these
to clinical findings.
KNOWLEDGE
Understand the relationship between the cytomorphology, histology and colposcopic
appearances of the cervix.
Understand the pathophysiology of malignancy of the female genital tract.
Understand the process of metaplasia and the types of metaplastic process seen in
female genital tract.
COMPETENCE
You must be able to:
Recognise and describe the cytological and histological features of a normal cervix.
Recognise and describe the cytological and histological features of metaplastic
processes.
Recognise and describe the cytological and histological features of dyskaryosis and
CIN.
Recognise and describe the cytological and histological features of malignancy.
Recognise and describe the cytological and histological features of glandular
abnormalities.
Relate all of the above to colposcopic findings.
Relate cytological and histological findings to clinical factors in health and disease.
86
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
87
7B.1b Cervical Screening Programmes
Be able to describe the rationale for cervical screening programmes.
KNOWLEDGE
Understand the theory and practice of screening programmes.
Understand the multidisciplinary nature of a cervical screening programme.
Understand the purpose, aims and organisation of the cervical screening programme
appropriate to your country of work.
Be aware of the cervical screening programmes of the other UK countries.
Understand the role cytology plays in a national screening programme.
COMPETENCE
You must be able to:
Access, analyse and interpret information relating to a cervical screening programme
(KC 53, KC61, KC65 data or equivalent).
Locate relevant documentation pertaining to the screening programme in the
laboratory (NHSCSP guidelines or equivalent).
Define epidemiological and statistical terms used in relation to screening.
Relate overall changes in the NHS to screening e.g. National Programme for
Information Technology.
88
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
89
7B.1c Aetiology and Epidemiology of Cervical Cancer
Be able to analyse data related to the incidence and prevalence of cervical cancer.
KNOWLEDGE
Understand the incidence and prevalence of cervical cancer and account for world
wide variation in rates.
Understand the relationship between risk factors, cervical neoplasia and cancer.
COMPETENCE
You must be able to:
Analyse and interpret data on incidence and mortality from national and international
statistics.
Relate risk factors to the development of cervical cancer
Explain the full range of risk factors and rank these factors for cervical cancer
predisposition.
90
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
91
7B.1d Quality Assurance and Audit
Be able to monitor your personal and your laboratory‟s performance relating results to
histological and colposcopic outcomes.
KNOWLEDGE
Understand the audit cycle.
Understand the principle of multidisciplinary audit.
Understand the quality assurance structure for the NHSCSP or equivalent.
Understand the importance of internal quality control as part of good laboratory
practice.
Understand the importance of external quality assessment as part of good laboratory
practice.
Understand how quality assurance data are used to help monitor the effectiveness of
the NHSCSP or equivalent.
Understand the principle of accreditation
Understand the role of NHSCSP Quality Assurance Team and the relationships with
the Hospital Based Programme Co-ordinator.
Understand the principles of error logging and Serious Untoward Incidents (SUIs).
COMPETENCE
You must be able to:
Interpret quality assurance data to analyse your own performance.
Identify performance outwith national performance indicators.
Interpret quality assurance data to analyse your laboratory‟s performance.
Prepare data for accreditation and QA visits.
Discuss the principles of error logging.
Participate in investigation of SUIs.
92
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
93
7B.1e Diagnosis and treatment of malignancies of the female genital tract.
KNOWLEDGE
Understand the wider clinical aspects of malignancy.
Understand the role of the gynaecologist in the diagnosis, treatment and
management of cervical and non-cervical disease.
Understand the role of multidisciplinary team meetings in the management of cancer.
Understand the difference between
(symptomatic) in non-cervical disease.
screening
and
clinical
presentation
COMPETENCE
You must be able to:
Describe the role of gynaecologist and colposcopist in the diagnosis, treatment and
management of malignancy.
Provide information for multidisciplinary team meeting as required.
Describe the process of staging in malignancy.
Describe treatment modalities.
94
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
95
7B.1f New Technologies and Ancillary Techniques in Screening
Be able to describe future developments and how these may impact on cervical screening.
KNOWLEDGE
Understand the scientific principles of semi-automated and automated scanning
devices.
Understand the technology and application of molecular biological techniques.
Understand the role of HPV testing.
Understand the underlying principles of vaccination.
COMPETENCE
You must be able to:
Describe the potential use of new technologies and how these may be introduced
into the NHSCSP or equivalent.
Describe how the principles of vaccination apply to the availability and introduction of
HPV vaccines.
Describe the use of molecular biological techniques, e.g. Polymerase Chain
Reaction (PCR), Hybrid Capture.
96
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
97
7B.1g Primary Care Processing
Be able to advise primary care staff on the laboratory requirements for obtaining the
correct sample, matching and transporting these samples.
KNOWLEDGE
Understand the role of primary care staff in obtaining samples for cervical screening.
Understand the principle of audit of sample takers.
Understand how transformation zone sampling is assessed.
COMPETENCE
You must be able to:
Liaise with and advise primary care staff on issues related to sampling.
Identify, refer or return mismatching or incomplete samples to smear takers.
Audit samples taken within a primary care service.
98
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
99
Reflective Log
This section is used to demonstrate you can relate knowledge from several areas, draw
conclusions and reflect on your own performance as an independent professional learner,
thus meeting the requirements for CPD. It is therefore a useful source of information for
your CPD profile should you be audited by the HPC.
The external assessor will review these reflective reports which should cross reference to
the evidence contained in the portfolio. This may lead to further discussion on the
laboratory tour.
Period of Training:
Summarise the laboratory role in the previous section(s):
Personal reflection on training and example of evidence:
7B.2 Non-cervical Cytopathology
7B.2a General Non-cervical Cytology
Be able to prepare and stain slides from non-cervical cytology samples.
KNOWLEDGE
Know the different types of sampling methods available.
Understand the importance of correct sampling.
Know the correct presentation and requirements for all types of non-cervical sample.
Understand how to prepare all types of non-cervical samples using a variety of
concentration methods, air drying or fixing as appropriate.
Understand how to prepare all types of non-cervical samples using routine staining
methods, specialised staining methods, and ancillary methods.
Understand the risks and hazards associated with fixed and unfixed samples
Understand the ethical and safe use, storage and disposal of residual samples and
stained preparations.
COMPETENCE
You must be able to:
Construct an accurate macroscopic description for all samples.
Optimally prepare all types of non-cervical sample.
Identify and rectify any problems encountered in specimen preparation.
Stain non-cervical preparations using routine stains, special stains or immunological
methods.
Complete all the relevant documentation (paper or electronic) in accordance with
quality assurance and audit requirements.
102
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
103
7B.2b Respiratory Tract
Be able to prepare, stain and evaluate cytology samples from the respiratory tract.
KNOWLEDGE
Understand the anatomy, physiology and histology of the respiratory tract.
Understand the disease processes affecting the respiratory tract.
Understand investigative methods used in respiratory tract disease.
Understand the relevance and importance of optimising preparatory techniques in
samples from respiratory tract cytology.
Understand the criteria for accessing the adequacy of samples.
Know the normal cytological features of sputum, bronchial washings, brushings and
lavages.
Know the cytological features of contaminants and artefacts including those related
to treatment of disease.
Know the cytological features and cytopathic effects of respiratory tract infections
including:
o
Aspergillus;
o
Candida;
o
Cytomegalovirus;
o
Pneumocystis carinii.
Be aware of the role of cytology in non-neoplastic pulmonary disease.
Know the cytological features and cytopathic effects of malignancy.
Know the cytological appearances of the following tumours:
o
Squamous carcinoma;
o
Small cell anaplastic carcinoma;
o
Adenocarcioma.
Be aware of diagnostic pitfalls.
COMPETENCE
You must be able to:
Work in accordance with standard operating procedures to optimise specimen
preparation utilising the range of techniques available.
Recognise common artefacts, contaminants and infective agents.
Recognise the difference between normal, reactive and malignant cells.
Complete all the relevant documentation (paper or electronic) in accordance with
quality assurance and audit requirements.
104
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
105
7B.2c Urinary Tract
Be able to prepare, stain and evaluate cytology samples from the urinary tract.
KNOWLEDGE
Understand the anatomy, histology and pathophysiology of the urinary tract.
Understand investigative methods used in diagnosing urinary tract disease.
Understand the principal behind industrial screening.
Understand the methods of sample collection.
Understand the relevance and importance of optimising preparatory techniques in
samples from urinary tract cytology.
Know the appearance of contaminants and artefacts.
Know the normal cytological features of urine samples.
Know the appearance and significance of the presence of crystals and casts in urine.
Know the appearance and/or cytopathic effects of urinary tract infections.
Understand iatrogenic changes in urinary tract.
Understand the cytomorphological features of neoplastic disease and malignancy.
Be aware of the grading criteria of papillary carcinoma.
Be aware of diagnostic pitfalls.
COMPETENCE
You must be able to:
Work in accordance with standard operating procedures to optimise specimen
preparation.
Recognise common artefacts, contaminants and infective agents.
Recognise the difference between normal, reactive and malignant cells.
Complete all the relevant documentation (paper or electronic) in accordance with
quality assurance and audit requirements.
106
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
107
7B.2d Serous Cavities
Be able to prepare, stain and evaluate serous fluids peritoneal washings and cytology
samples from serous cavities.
KNOWLEDGE
Know the anatomy, histology and pathophysiology of body cavities.
Know the methods for collection and preparation of serous effusions.
Understand the relevance and importance of optimising preparatory techniques in
samples from serous cavities.
Be aware of the process and significance of serous effusion formation and
associated clinical conditions.
Know the normal cytological features of effusions.
Know and can recognise the cytological features associated with reactive changes in
serous effusions.
Understand the cytomorphological features of malignancy.
Know how to recognise the cytological features of metastatic disease in serous
effusions.
Know how to recognise the significant features associated with malignant
mesothelioma and methods of confirmation.
Understand differential diagnoses and potential diagnostic pitfalls.
COMPETENCE
You must be able to:
Work in accordance with standard operating procedures to optimise specimen
preparation.
Recognise the difference between normal, reactive and malignant cells.
Complete all the relevant documentation (paper or electronic) in accordance with
quality assurance and audit requirements.
108
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
109
7B.2e Fine Needle Aspiration Collection and Preparation
Be able to prepare, stain and evaluate samples when attending fine needle aspirations.
KNOWLEDGE
Understand the theory of fine needle aspiration techniques in superficial sites and
utilising imaging techniques.
Understand procedures available to optimise sample preparation.
COMPETENCE
You must be able to:
Optimise specimen preparation.
Stain slides in accordance with standard operating procedures and critically evaluate
results.
Complete all the relevant documentation (paper or electronic) in accordance with
quality assurance and audit requirements.
110
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
111
7B.2f Laboratory Procedures
Be able to evaluate immediately prepared non-cervical cytology samples.
KNOWLEDGE
Understand the relationship between cell structure and function.
Know the normal cytological features of abraded, aspirated and exfoliated material
from tissues or epithelia.
Know the general cytological features of reactive and malignant cells.
Understand how to correlate cytological features with histology.
Understand the relevance of immediate diagnosis.
Be aware of the current government recommendation on cancer waiting times.
COMPETENCE
You must be able to:
Set up and use a microscope.
Recognise normal cells from a variety of non-cervical samples.
Stain and assess immediately made cytology preparations, either in the laboratory or
at a remote location.
Complete all the relevant documentation (paper or electronic) in accordance with
quality assurance and audit requirements.
112
EVIDENCE OF ACHIEVEMENT
This section requires the trainer to sign that the specialist trainee has successfully
achieved fitness to practice as a biomedical scientist at the specialist level. The
specialist trainee is required to present the supporting evidence indicated below as a
separate specialist portfolio of evidence.
Assessed by trainer to work in accordance with standard laboratory procedures.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Answered questions set by trainer on the principles and practice of named
procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
Date of completion:
Trainer‟s name:
Trainer‟s signature:
Evidence of competence for this standard has been assessed and passed by the
internal person who has checked that the requirements in the Evidence of
Achievement section have been met.
Internal Assessor‟s signature:
Internal Assessor‟s name:
Date:
113
Reflective Log
This section is used to demonstrate you can relate knowledge from several areas, draw
conclusions and reflect on your own performance as an independent professional learner,
thus meeting the requirements for CPD. It is therefore a useful source of information for
your CPD profile should you be audited by the HPC.
The external assessor will review these reflective reports which should cross reference to
the evidence contained in the portfolio. This may lead to further discussion on the
laboratory tour.
Period of Training:
Summarise the laboratory role in the previous section(s):
Personal reflection on training and example of evidence:
About this document
Document title:
Record of Laboratory Training for the Specialist Diploma in
Cytopathology
Produced by:
Cytopathology Advisory Panel
Contact:
Executive Head of Education on [email protected]
Version:
Edition 3
Date active:
September 2011
Comments:
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