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:
IBMS Membership Grade:
HPC Registration Number:
Date of HPC Registration:
Employment Address:
Telephone Number:
Date Specialist Training Commenced:
Name of Training Officer:
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
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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
7.1
Primary Investigations of Blood and its Components .......................................... 38
Cell Counting and Haemoglobin Concentration Measurement ..................... 38
7.1b
Erythrocyte Sedimentation Rates (ESR)/Plasma Viscosity .......................... 40
7.1c
Identification and Enumeration of Peripheral Blood Cells by Microscopy ..... 42
7.1d
Infectious Mononucleosis ............................................................................. 44
7.1e
Sickle Cell ..................................................................................................... 46
7.1f
Malaria Parasites .......................................................................................... 48
7.1g
Haemostasis Function .................................................................................. 50
7.1h
Fibrinogen ..................................................................................................... 52
7.1i
Fibrin Degradation Products ......................................................................... 54
7.1j
Anticoagulant Therapy .................................................................................. 56
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Iron Deficiency Anaemia and Iron Overload ........................................................ 60
7.2a
7.3
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7.2
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7.1a
Iron Deficiency Anaemia and Iron Overload ................................................. 60
Haemolytic Anaemia ............................................................................................ 64
7.3a
Haemolytic Anaemia Screening Tests .......................................................... 64
7.3b
Inherited and Acquired Haemolytic Anaemia ................................................ 66
7.4
Abnormal Haemoglobins and Thalassaemia ....................................................... 70
7.4a
Haemoglobin Variants (HbS, C, D, E) .......................................................... 70
7.4b
Imbalanced Globin Chain Production ........................................................... 72
7.4c
Unstable Haemoglobin ................................................................................. 74
7.5
Megaloblastic Anaemia ........................................................................................ 78
7.5a
Vitamin B12 Deficiency ................................................................................. 78
7.5b
7.6
Folate Deficiency .......................................................................................... 80
Haematological Malignancies .............................................................................. 84
7.6a
White Cell Malignancy .................................................................................. 84
7.6b
Polycythaemia .............................................................................................. 86
7.7
Haemostasis Abnormalities ................................................................................. 90
7.7a
Bleeding Disorders ....................................................................................... 90
7.7b
Thrombotic Disorders ................................................................................... 92
7.7c
Lupus Anticoagulant ..................................................................................... 94
7.8
Hospital Transfusion Practice .............................................................................. 98
Routine ABO/D typing and antibody screening ............................................ 98
7.8b
ABO and RhD Anomalies ........................................................................... 102
7.8c
Antibody Identification................................................................................. 106
7.8d
Red Cell Phenotyping ................................................................................. 108
7.8e
Selection of Red Cells and Components .................................................... 110
7.8f
Procedures for Establishing Compatibility .................................................. 114
7.8g
Issuing of blood components and products ................................................ 116
7.8h
Blood Stocks Management ......................................................................... 118
7.8i
Adverse Reactions and Events in Transfusion ........................................... 120
7.8j
Antenatal Testing and Procedures ............................................................. 122
7.8k
Haemolytic Disease of the Fetus and Newborn .......................................... 126
7.8l
Investigation of Red Cell Autoantibodies .................................................... 128
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7.8a
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1. INTRODUCTION
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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.
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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.
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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.
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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.
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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.
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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.
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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
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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.
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Knowledge and understanding
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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.
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Professional skills
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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.
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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
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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.
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a.
Questions set by trainer
b.
Other evidence
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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).
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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.
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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.
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A glossary of commonly used terms is listed in Section 6.
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PLEASE NOTE:
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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
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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
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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.
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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.
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3.8
i)
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
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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;
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Check that professional body guidelines and criteria are applied nationally;
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Reassure the employer that their training is to the appropriate standard;
Disseminate areas of good practice;
Provide constructive feedback on areas of unsatisfactory practice.
Role of the External Assessor appointed by the Institute
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4.3
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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.
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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.
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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.
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The external assessor may wish to ask some questions related to the presentation
or seek points of clarification.
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Stage 2: Portfolio Assessment (Indicative time 60 mins)
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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.
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The signed assessment of practice does not require a separate witness
statement (unlike the Registration Portfolio).
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“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.
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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…).
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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.
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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
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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.
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Stage 5: Feedback Comments to Trainer and Candidates.
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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.
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Stage 6: Completion of Reports
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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.
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
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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?
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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.
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The charge by the Institute for the specialist portfolio is £125. Who should pay?
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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?
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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.
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How long will it take for a date to be set for my assessment?
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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.
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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?
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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.
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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?
Who signs?
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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).
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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.
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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?
R
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.
e
er
ef
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.
nc
Do I need to complete all sections of the portfolio?
e
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.
op
C
How long does training take?
y
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?
R
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ef
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?
nc
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.
e
When can I do on-call?
C
y
op
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
R
e
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y
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C
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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.
R
COMPETENT
e
er
ef
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.
nc
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.
e
Suggested examples of evidence:
C
Audit trail results
Annotated photomicrographs
op
EVIDENCE OF
ACHIEVEMENT
Annotated copies of QC/EQA records
Tutorial notes for question and answer sessions
y
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.
R
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nc
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y
op
C
34
7. DISCIPLINE SPECIFIC
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nc
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y
op
C
7.
DISCIPLINE SPECIFIC
This section covers the range of tests appropriate to specialist practice in Haematology
and Hospital Transfusion Practice 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.
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.
R
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. Clinical Biochemistry, Clinical Immunology.
e
er
ef
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.
nc
e
Please note: The UK Transfusion Laboratory Collaborative: Recommended
minimum standards for hospital transfusion laboratories (March 2009)
recommends in section 3.2 that all lone working staff working, whether working
supervised or unsupervised will have attained an appropriate qualification. It is
therefore expected that all individuals complete the full range of modules pertaining
to the IBMS Specialist Portfolios for either Transfusion Science or Haematology
with Hospital Transfusion Practice.
y
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C
37
7.1
Primary Investigations of Blood and its Components
7.1a Cell Counting and Haemoglobin Concentration Measurement
Be able to perform cell counting by automated methods.
KNOWLEDGE
Understand the principles and practice of optical and impedance automated cell
counting methods for:
Leucocytes;
o
Erythrocytes;
o
Platelets;
o
Reticulocytes;
o
White cell differentials.
R
o
e
er
ef
Understand the use of calibration and control materials and how to deal with out of
limit values.
Know the correct preparation of samples for testing and pre-analytical factors that
could affect accuracy of the results.
nc
Know the effects of haemolysis, lipaemia, icterus and storage conditions on
laboratory results.
Understand the use of reference values and the significance of abnormal results.
e
Be aware of the limitations of tests and further investigations that may be required.
COMPETENCE
y
You must be able to:
op
C
Know the relevant internal and external quality assurance procedures.
Check the suitability of sample quality for analysis.
Match sample to patient unique identification and confirm urgency of analysis.
Prepare and operate named automated analysers for routine use.
Perform analysis In accordance with standard laboratory procedure.
Critically evaluate results.
Complete all relevant documentation (paper or electronic) in accordance with quality
assurance and audit requirements.
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.1b Erythrocyte Sedimentation Rates (ESR)/Plasma Viscosity
Be able to perform by manual or automated technique ESR or plasma viscosity
measurement.
KNOWLEDGE
Understand the principles and purpose of ESR measurement and environmental
effects on the accuracy of results.
Know the principles and purpose of measurement of plasma viscosity.
Be aware of the relevance of these measurements in the diagnosis of disease.
Know the principles of instrumentation used for ESR and plasma viscosity
measurement.
Know the reference values and the significance of abnormal results.
Understand the relevant internal and external quality assurance procedures.
R
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ef
COMPETENCE
You must be able to:
Prepare and operate named automated analysers for routine use.
Prepare sample for manual ESR technique if method is used locally.
nc
Perform named test in accordance with standard laboratory procedure.
e
Identify abnormal results and likely significance to clinical detail.
y
op
C
Complete all relevant documentation in accordance with quality control and audit
requirements.
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.1c Identification and Enumeration of Peripheral Blood Cells by Microscopy
Be able to identify normal and abnormal peripheral blood cells and perform
quantitative/qualitative analysis by microscopy.
KNOWLEDGE
Know the principles and application of light microscopy.
Understand the principles and practice of staining blood cells by Romanowsky
staining.
Know the pre-analytical variables that will affect appearance of blood cells.
Understand the mechanisms of normal haemopoiesis.
Understand the clinical significance of normal and abnormal red cell morphology and
the relationship to red cell indices.
Know the normal morphological features of the myeloid and lymphoid series of white
blood cells.
R
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ef
Be aware of the significance of abnormal or immature white blood cells on the
peripheral blood film.
Know the normal reference values and the significance of abnormal results.
Know the morphological and serological features of infectious mononucleosis.
Know the relevant internal and external quality assurance procedures.
e
You must be able to:
nc
COMPETENCE
op
Set up microscope for viewing blood film.
C
Prepare and stain blood films of suitable quality for morphological analysis.
Accurately identify morphological features of normal and abnormal cells.
y
Perform test in accordance with standard laboratory procedures.
Manually enumerate WBC differential count.
Estimate platelet count from the blood film and confirm accuracy of automated count.
Assess platelet clumping and adhesion to neutrophils.
Identify possible abnormalities and likely significance to clinical details.
Refer samples for further testing according to abnormalities.
Complete all relevant documentation (paper or electronic) in accordance with quality
assurance and audit requirements.
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.1d Infectious Mononucleosis
Be able to perform a screening test for infectious mononucleosis.
KNOWLEDGE
Understand the principles and practice of the screening test for infectious
mononucleosis (IM).
Know the blood count, serological and morphological features of infectious
mononucleosis.
Be aware of the limitations of IM screening tests.
Know the relevant internal and external quality assurance procedures.
COMPETENCE
R
You must be able to:
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Perform test in accordance with standard laboratory procedure.
Clearly distinguish between positive, negative and equivocal results.
Complete all relevant documentation in accordance with quality control and audit
requirements.
e
nc
y
op
C
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.1e Sickle Cell
Be able to perform a screening test for HbS disorders.
KNOWLEDGE
Understand the principles and practice of the screening test for HbS disorders.
Know the blood count and morphological features of sickle cell disorders.
Be aware of the limitations of sickle cell screening tests.
Know the relevant internal and external quality assurance procedures.
COMPETENCE
You must be able to:
R
Prepare sample and perform test in accordance with standard laboratory procedure.
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ef
Clearly distinguish between positive, negative and equivocal results.
Complete all relevant documentation in accordance with quality control and audit
requirements.
Describe local clinical procedures to follow up positive or negative results.
e
nc
y
op
C
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.1f
Malaria Parasites
Be able to perform screening tests for malaria parasites.
KNOWLEDGE
Be aware of the geographical occurrence of malaria.
Know the techniques for detecting the presence of malaria parasites, including:
o
Thick and thin blood films;
o
Use of different stains;
o
Immunochromatography.
Be aware of the presenting clinical symptoms of suspected cases and
haematological changes.
Know the different types of malaria parasites.
R
Be aware of the life cycle of malarial parasites and the stages found in the blood.
e
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ef
Be aware of the effect of drug treatment on detection.
Be aware of the limitations of techniques employed.
Know the relevant internal and external quality assurance procedures.
e
You must be able to:
nc
COMPETENCE
C
Prepare sample and perform test in accordance with standard laboratory procedure.
op
Clearly distinguish between positive, negative and equivocal results.
y
Complete all relevant documentation in accordance with quality control and audit
requirements.
Describe the local clinical procedures to follow up positive or negative results.
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.1g Haemostasis Function
Be able to perform measurement of prothrombin time and activated partial thromboplastin
time in screening for haemostasis function.
KNOWLEDGE
Know the components of the haemostatic pathways and their modes of action.
Understand the principles and practice of the technique for measuring prothrombin
time (PT) and which clotting factors are measured.
Understand the principles and practice of the techniques for measuring activated
partial thromboplastin time (APTT) and which clotting factors are measured.
Know the principles of instrumentation used to assess haemostasis function.
Know the pre-analytical variables that can affect results.
Know the normal reference values and the significance of abnormal results.
R
Be aware of the effects of anticoagulant therapy on PT and APTT measurement.
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Be aware of the relationship between abnormal PT and APTT and other laboratory
tests, e.g. full blood count and liver function tests.
Understand the principles and practice of the technique for measuring thrombin time
(TT) and Reptilase time (RT).
nc
Know the relevant internal and external quality assurance procedures.
Check the suitability of sample quality for analysis.
op
C
You must be able to:
e
COMPETENCE
y
Match sample to patient unique identification and confirm urgency of analysis.
Perform analysis in accordance with standard laboratory procedure.
Critically evaluate results.
Identify samples that may require further investigations.
Complete all relevant documentation (paper or electronic) in accordance with 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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.1h Fibrinogen
Be able to perform fibrinogen estimation.
KNOWLEDGE
Know the components of the haemostatic pathways and their modes of action.
Understand the laboratory investigation and clinical emergency of suspected
disseminated intravascular coagulation (DIC).
Understand the principles and practice of fibrinogen estimation.
Know the principles of instrumentation used to estimate fibrinogen.
Know the pre-analytical variables that can affect results.
Know the normal reference values and the significance of abnormal results.
Know the relevant internal and external quality assurance procedures.
R
e
er
ef
COMPETENCE
You must be able to:
Check the suitability of sample quality for analysis.
nc
Match sample to patient unique identification and confirm urgency of analysis.
Prepare assay reagents and controls for use.
e
Prepare and operate named automated analysers for use.
C
Prepare and check controls are within acceptable limit.
op
Perform analysis in accordance with standard laboratory procedure.
Identify samples that may require further investigations.
y
Identify problems that may affect result and take remedial action.
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.1i
Fibrin Degradation Products
Be able to perform fibrin degradation product estimation.
KNOWLEDGE
Know the components of the haemostatic pathways and their modes of action.
Understand the principles and practice of fibrin degradation products estimation.
Know the principles of instrumentation or manual method used to detect fibrin
degradation products.
Know the pre-analytical variables and interacting substances that can affect results.
Know the normal reference values and the significance of abnormal results.
Be aware of the use of D-dimer for the investigation of suspected cases of venous
thromboembolism.
R
Know the relevant internal and external quality assurance procedures.
e
er
ef
COMPETENCE
You must be able to:
Check the suitability of sample quality for analysis.
nc
Match sample to patient unique identification and confirm urgency of analysis.
e
Perform analysis in accordance with standard laboratory procedure.
C
Identify problems that may effect result and take remedial action.
op
Identify samples that may require further investigations or action.
y
Complete all relevant documentation (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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.1j
Anticoagulant Therapy
Be able to perform monitoring of anticoagulant therapy in accordance with laboratory
procedures.
KNOWLEDGE
Know the principles of heparin and oral anticoagulant (OA) therapy.
Understand the principles and practice of monitoring heparin anticoagulant therapy,
inclusive of unfractionated and Low Molecular Weight Heparin Therapy (LMWHT)
forms.
Understand the principles and practice of the International Normalised Ratio (INR)
system for monitoring OA therapy.
Know the principles of instrumentation used to determine INR.
Know the pre-analytical variables that can affect results.
R
Know the therapeutic ranges and significance of out of range results.
e
er
ef
Be aware of the principles and practice of direct thrombin inhibitor (DTI) therapy and
monitoring.
Know the relevant internal and external quality assurance procedures.
You must be able to:
e
nc
COMPETENCE
Check the suitability of sample quality for analysis.
C
Match sample to patient unique identification and confirm urgency of analysis.
op
Prepare test reagents and controls for use.
Prepare and check controls are within acceptable limit.
y
Prepare and performed INR in accordance with standard laboratory procedure.
Identify problems that may effect result and take corrective action.
Identify samples that may require further investigations or action.
Complete all 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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
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):
R
e
nc
e
er
ef
y
op
C
Personal reflection on training and example of evidence:
R
e
nc
e
er
ef
y
op
C
7.2
Iron Deficiency Anaemia and Iron Overload
7.2a Iron Deficiency Anaemia and Iron Overload
Be able to perform investigations for iron status abnormalities.
KNOWLEDGE
Be aware of normal erythropoiesis and production of haemoglobin.
Be aware of normal iron metabolism and storage.
Understand the effect of iron deficiency on red cell indices.
Understand the effect of iron overload on red cell indices.
Be aware of clinical causes of iron deficiency and iron overload.
R
Be aware of laboratory tests available to assess iron status (e.g. serum ferritin,
serum transferrin, serum iron, zinc protoporphyrin).
e
er
ef
Know the pre-analytical variables that can affect results.
Know the normal reference values and the significance of abnormal results.
Know the relevant internal and external quality assurance procedures.
e
You must be able to:
nc
COMPETENCE
C
Check the suitability of sample quality for analysis.
op
Match sample to patient unique identification and confirm urgency of analysis.
Perform named techniques in accordance with standard laboratory procedure.
y
Identify problems that may effect result and take corrective action.
Identify samples that may require further investigations or action.
Complete all relevant documentation (paper or electronic) in accordance with quality
assurance and audit requirements.
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
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):
R
e
nc
e
er
ef
y
op
C
Personal reflection on training and example of evidence:
R
e
nc
e
er
ef
y
op
C
7.3
Haemolytic Anaemia
7.3a Haemolytic Anaemia Screening Tests
Be able to perform screening tests for the laboratory investigation of haemolytic anaemia.
KNOWLEDGE
Be aware of the causes of hereditary and acquired haemolytic anaemia.
Know the peripheral blood morphology features associated with haemolytic anaemia.
Know the principles of screening tests to identify the occurrence of haemolysis,
including:
Reticulocyte count;
o
Serum haptoglobin;
o
Urinary haemosiderin;
o
Methaemoglobin.
R
o
e
er
ef
Know the normal reference values and the significance of abnormal results.
Know the relevant internal and external quality assurance procedures.
e
You must be able to:
nc
COMPETENCE
C
Check the suitability of sample quality for analysis.
op
Match sample to patient unique identification and confirm urgency of analysis.
Perform named techniques in accordance with standard laboratory procedures.
y
Identify problems that may effect result and take corrective action.
Identify samples that may require further investigations or action.
Complete all relevant documentation (paper or electronic) in accordance with quality
assurance and audit requirements.
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.3b Inherited and Acquired Haemolytic Anaemia
Be able to perform the investigation of inherited and acquired haemolytic anaemia.
KNOWLEDGE
Be aware of the causes of hereditary and acquired haemolytic anaemia.
Know the blood morphology features associated with haemolytic anaemias.
Know the principles and limitations of techniques to identify membrane abnormalities
(e.g. osmotic fragility).
Know the principles and limitations of techniques to identify enzyme deficiencies
(e.g. G-6-PD, pyruvate kinase).
Know the principles and limitations of techniques to identify acquired immune
haemolytic anaemia (e.g. DAT, presence of cold or warm reacting antibodies).
R
Know the principles and limitations of techniques to identify acquired non-immune
haemolytic anaemia (e.g. PNH, malaria).
e
er
ef
Know the normal reference values and the significance of abnormal results.
Know the relevant internal and external quality assurance procedures.
You must be able to:
nc
COMPETENCE
e
Check the suitability of sample quality for analysis.
C
Match sample to patient unique identification and confirm urgency of analysis.
op
Performed named techniques in accordance with standard laboratory procedures.
Identify problems that may effect result and take corrective action.
y
Identify samples that may require further investigations or action.
Complete all relevant documentation (paper or electronic) in accordance with quality
assurance and audit requirements.
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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):
R
e
nc
e
er
ef
y
op
C
Personal reflection on training and example of evidence:
R
e
nc
e
er
ef
y
op
C
7.4
Abnormal Haemoglobins and Thalassaemia
7.4a Haemoglobin Variants (HbS, C, D, E)
Be able to perform analysis for the detection abnormal haemoglobin variants.
KNOWLEDGE
Know the normal structure of the haemoglobin molecule.
Be aware of the structural variants leading to haemoglobin abnormalities (e.g. HbS).
Understand the structural difference and significance between severe and trait forms
of haemoglobinopathies.
Be aware of combined defects (e.g. HbSC, HbS/alpha thalassaemia).
Know the red cell indices and blood morphology features associated with abnormal
haemoglobin variants.
R
e
er
ef
Understand the principles and practice of relevant techniques for the detection and
investigation of abnormal haemoglobin variants.
Know the reference values and the significance of abnormal results.
Know the relevant internal and external quality assurance procedures.
e
You must be able to:
nc
COMPETENCE
C
Check the suitability of sample quality for analysis.
op
Match sample to patient unique identification and confirm urgency of analysis.
Perform analysis in accordance with standard laboratory procedure.
y
Identify problems that may effect result and take corrective action.
Identify samples that may require further investigations or action.
Complete all 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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.4b Imbalanced Globin Chain Production
Be able to perform techniques for the detection and quantification of abnormal
haemoglobins due to imbalance in globin chain production.
KNOWLEDGE
Know the normal structure of the haemoglobin molecule.
Be aware of the imbalanced globin chain production leading to the thalassaemias.
Know the globin chain composition of severe and trait forms of alpha and betathalassaemias, HbH and HbBarts.
Be aware of combined defects.
Know the red cell indices and blood morphology features associated with the
thalassaemias.
R
Understand the principles and practice of relevant techniques for the detection and
investigation of imbalanced globin chain production.
e
er
ef
Know the reference values and the significance of abnormal results.
Know the relevant internal and external quality assurance procedures.
You must be able to:
nc
COMPETENCE
e
Check the suitability of sample quality for analysis.
C
Match sample to patient unique identification and confirm urgency of analysis.
op
Perform analysis according to standard laboratory procedure.
Identify problems that may affect the result and take corrective action.
y
Identify samples that may require further investigations or action.
Complete all 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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.4c Unstable Haemoglobin
Be able to perform techniques for the detection of unstable haemoglobin.
KNOWLEDGE
Know the normal structure of the haemoglobin molecule.
Be aware of the mutations in globin chains leading to the production of unstable
haemoglobin.
Know the red cell indices and blood morphology features associated with unstable
haemoglobin.
Understand the principles and practice of relevant techniques for detection of
unstable haemoglobin.
Know the significance of abnormal results.
Know the relevant internal and external quality assurance procedures.
R
e
er
ef
COMPETENCE
You must be able to:
Check the suitability of sample quality for analysis.
nc
Match sample to patient unique identification and confirm urgency of analysis.
Perform analysis according to standard laboratory procedure.
e
Identify problems that may affect the result and take corrective action.
C
Identify samples that may require further investigations or action.
op
Complete all relevant documentation (paper or electronic) in accordance with quality
assurance and audit requirements.
y
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
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):
R
e
nc
e
er
ef
y
op
C
Personal reflection on training and example of evidence:
R
e
nc
e
er
ef
y
op
C
7.5
Megaloblastic Anaemia
7.5a Vitamin B12 Deficiency
Be able to perform techniques to measure vitamin B12 status.
KNOWLEDGE
Be aware of the metabolism of vitamin B12 and its role in haemopoiesis.
Be aware of the causes of vitamin B12 deficiency.
Know the changes in blood cell indices and morphological features associated with
B12 deficiency.
Understand the principles and practice of relevant techniques for the measurement
of vitamin B12.
Be aware of the limitations of tests and further investigations that may be required.
R
Know the reference values and the significance of abnormal results.
e
er
ef
Know the relevant internal and external quality assurance procedures.
COMPETENCE
nc
You must be able to:
Check the suitability of sample quality for analysis.
e
Match sample to patient unique identification and confirm urgency of analysis.
C
Perform analysis according to standard laboratory procedure.
op
Identify problems that may affect result and take corrective action.
y
Identify samples that may require further investigations or action.
Complete all 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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.5b Folate Deficiency
Be able to perform techniques to measure folate status.
KNOWLEDGE
Be aware of the metabolism of folate and its role in haemopoiesis.
Be aware of the causes of folate deficiency.
Know the changes in blood cell indices and morphological features associated with
folate deficiency.
Understand the principles and practice of relevant techniques for the measurement
of serum and red cell folate.
Be aware of the limitations of tests and further investigations that may be required.
Know the reference values and the significance of abnormal results.
R
Know the relevant internal and external quality assurance procedures.
e
er
ef
COMPETENCE
You must be able to:
Check the suitability of sample quality for analysis.
nc
Match sample to patient unique identification and confirm urgency of analysis.
e
Perform analysis of sample in accordance with standard laboratory procedure.
C
Identify problems that may affect the result and take corrective action.
op
Identify samples that may require further investigations or action.
y
Complete all 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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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):
R
e
nc
e
er
ef
y
op
C
Personal reflection on training and example of evidence:
R
e
nc
e
er
ef
y
op
C
7.6
Haematological Malignancies
7.6a White Cell Malignancy
Be able to perform techniques to investigate white cell abnormalities.
KNOWLEDGE
Be aware of the mechanism of normal haemopoietic cell production and
differentiation, and the consequences of abnormality.
Be aware of the classification of haematological malignancies.
Know the changes in peripheral blood cell indices and morphological features
associated with white cell abnormalities, including:
Leucocytosis;
o
Leucopenia;
o
Acute leukaemia;
o
Chronic lymphocytic leukaemia;
o
Myelodysplastic disorders;
o
Myeloproliferative disorders.
R
o
e
er
ef
Understand the principles and practice of relevant techniques for the investigation of
white cell abnormalities in peripheral blood, including:
o
Immunophenotyping;
o
Cytogenetics.
e
Cytochemistry;
nc
o
Be aware of the limitations of tests and further investigations that may be required.
C
Know reference values and significance of abnormal results.
op
Know the relevant internal and external quality assurance procedures.
y
COMPETENCE
You must be able to:
Check the suitability of sample quality for analysis.
Match sample to patient unique identification and confirm urgency of analysis.
Perform analysis according to standard laboratory procedure.
Identify problems that may effect result and take corrective action.
Identify samples that may require further investigations or action.
Complete all relevant documentation (paper or electronic) in accordance with quality
assurance and audit requirements.
84
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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:
85
7.6b Polycythaemia
Be able to describe techniques to investigate increased red cell count.
KNOWLEDGE
Be aware of the mechanism of normal haemopoietic cell production and
consequences of abnormalities in red cell production.
Be aware of the pathophysiology of primary and secondary polycythaemias.
Know the changes in blood cell indices and morphological features associated with
polycythaemias.
Understand the principles and practice of relevant techniques for the investigation of
increased red cell counts.
Be aware of the limitations of tests and further investigations that may be required.
Know reference values and significance of abnormal results.
R
Know the relevant internal and external quality assurance procedures.
e
er
ef
COMPETENCE
You must be able to:
nc
Describe how to perform analysis according to standard laboratory procedure.
Identify problems that may effect result and take corrective action.
e
y
op
C
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
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):
R
e
nc
e
er
ef
y
op
C
Personal reflection on training and example of evidence:
R
e
nc
e
er
ef
y
op
C
7.7
Haemostasis Abnormalities
7.7a Bleeding Disorders
Be able to perform techniques for the investigation of bleeding disorders.
KNOWLEDGE
Understand the principles and components of the haemostatic pathways.
Understand the principles and significance of the screening tests for coagulation and
the clotting factors, which are measured by the PT, APTT and TT.
Be aware of the coagulation abnormalities associated with the haemophilia A and B
and von Willebrand‟s disease and other factor deficiencies.
Be aware of the coagulation abnormalities associated with acquired defects.
Be aware of the bleeding abnormalities, associated with platelet and vessel defects.
R
Be aware of replacement therapy.
e
er
ef
Understand the principles and practice of techniques to assess specific coagulation
factor deficiencies (e.g. one-stage clotting assays).
Understand the principles and practice of techniques to detect presence of
coagulation factor inhibitors.
nc
Understand the principles and practice of techniques to assess platelet function.
e
Know the pre-analytical variables that can affect results.
Understand the normal reference values and the significance of abnormal results.
C
Know the relevant internal and external quality assurance procedures.
y
You must be able to:
op
COMPETENCE
Check the suitability of sample quality for analysis.
Match sample to patient unique identification and confirm urgency of analysis.
Perform analysis according to standard laboratory procedure.
Identify problems that may effect result and take corrective action.
Identify samples that may require further investigations or action.
Complete all relevant documentation (paper or electronic) in accordance with quality
assurance and audit requirements.
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.7b Thrombotic Disorders
Be able to perform techniques for the investigation of thrombotic disorders.
KNOWLEDGE
Understand the principles and components of the haemostatic pathways and its
natural inhibitors.
Be aware of the thrombotic risks associated with reduced levels of inhibitors and cofactors.
Be aware of the thrombotic risks associated with defects that are detected using
genetic analysis, including:
o
Factor V Leiden;
o
Prothrombin gene mutation.
R
Understand the principles and practice of techniques to investigate thrombotic risk
associated with thrombosis, including:
Clotting;
o
Chromogenic;
o
Immunoassays.
e
er
ef
o
Know the pre-analytical variables that can affect results.
nc
Understand the normal reference values and the significance of abnormal results.
e
Know the relevant internal and external quality assurance procedures.
You must be able to:
y
Check the suitability of sample quality for analysis.
op
C
COMPETENCE
Match sample to patient unique identification and confirm urgency of analysis.
Perform analysis according to standard laboratory procedures.
Identify problems that may effect result and take corrective action.
Identify samples that may require further investigations or action.
Complete all relevant documentation (paper or electronic) in accordance with quality
assurance and audit requirements.
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.7c Lupus Anticoagulant
Be able to perform investigations to detect lupus anticoagulant.
KNOWLEDGE
Understand the principles and components of haemostatic pathways.
Understand what is meant by the term “lupus anticoagulant”.
Be aware of the relationship between lupus anticoagulant and antiphospholipid
antibodies.
Understand the principles and significance of the screening tests for coagulation and
the potential influence of lupus anticoagulant on them.
Be aware of the effect of lupus anticoagulant on clotting based tests (e.g. INR, onestage factor assays).
R
Understand the principles and limitations of techniques to demonstrate the presence
of lupus anticoagulant.
e
er
ef
Know the pre-analytical variables that can affect results.
Know the normal reference values and the significance of abnormal results.
Know the relevant internal and external quality assurance procedures.
e
You must be able to:
nc
COMPETENCE
C
Check the suitability of sample quality for analysis.
op
Match sample to patient unique identification and confirm urgency of analysis.
Perform assay in accordance with standard laboratory procedure.
y
Identify problems that may effect result and take corrective action.
Identify samples that may require further investigations or action.
Complete all relevant documentation (paper or electronic) in accordance with quality
assurance and audit requirements.
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
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):
R
e
nc
e
er
ef
y
op
C
Personal reflection on training and example of evidence:
R
e
nc
e
er
ef
y
op
C
7.8
Hospital Transfusion Practice
7.8a Routine ABO/D typing and antibody screening
Be able to perform patient ABO/D typing and antibody screening
KNOWLEDGE
Understand the basis of the major blood group systems - genes, antigens, and
antibodies, and their clinical significance in transfusion medicine.
Know the principles of the indirect antiglobulin test (IAT), and of commonly used
technologies available for detection of clinically significant antibodies.
Know the factors affecting antigen-antibody reactions in-vitro.
Know the principles of serological tests used in manual and automated blood
grouping and antibody screening, their appropriate use and potential sources of error.
R
Understand the increased security afforded by the electronic transfer of ABO/D and
antibody screening results from automation to the LIMS.
e
er
ef
Know the specifications of reagents for patient blood grouping and antibody
screening, the rationale behind their selection, and controls required depending on
the testing system and methods used.
nc
Understand the use of potentiators in routine reagents and the potential difficulties in
result interpretation.
e
Know how to validate reagents prior to use and actions to take in any cases where
validation fails.
op
C
Know the minimum specifications for blood grouping in emergency situations, and
before the issue of group compatible blood.
Know the relevance of erroneous and anomalous results patient testing.
Know the relevant internal and external quality assurance procedures.
y
Be aware of local policies and procedures and national guidelines covering all of the
above.
98
COMPETENCE
You must be able to:
Apply sample acceptance criteria and demonstrate understanding of the risks
associated with inadequately labelled samples in transfusion
Perform indirect antiglobulin tests (IAT) and demonstrate an understanding of
possible sources of error dependent on the technology used and the patient‟s clinical
condition.
Perform blood grouping and antibody screening tests using manual and automated
methods.
Complete all relevant documentation accurately and in accordance with quality
control and audit requirements, use IT and follow procedures to minimize the risk of
transcription error.
Select and apply appropriate controls, recognise control failures and identify further
actions required.
R
e
er
ef
Interpret patient blood grouping and antibody screening results, recognise anomalies
and identify further actions required.
Provide safe blood components for patients (if clinically necessary) before a
confirmed ABO/D result can be established.
e
nc
y
op
C
99
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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:
100
R
e
nc
e
er
ef
y
op
C
7.8b ABO and RhD Anomalies
Be able to investigate ABO/D typing anomalies and assign safe ABO/D groups to patients.
KNOWLEDGE
Understand the clinical and laboratory factors that may affect results of ABO and D
typing.
Understand the clinical and laboratory factors that may lead to anomalous results of
ABO and D typing.
Know the principle and practice of investigating blood group anomalies in specific
patients groups, for example paediatric, elderly and immune suppressed patients.
Know the principles and practice of investigating blood group anomalies in a variety of
clinical and technical scenarios, including:
Haemopoietic stem cell transplantation;
o
Presence of cold agglutinins;
o
Transfusion reactions;
o
Potential „wrong blood in tube‟.
R
o
e
er
ef
Know the scientific basis and significance of ABO subgroups and weak / partial D
types in patients.
nc
Understand the limitations of testing when using rare antisera.
e
Know how to interpret anomalous grouping results in clinical and laboratory
circumstances and select safe and appropriate components for the patient.
op
C
Understand the criteria and trigger factors for further testing or referral before a blood
group can be assigned.
Be aware of local policies and procedures and national guidelines covering all of the
above.
y
102
COMPETENCE
You must be able to:
Prepare samples and select reagents and controls.
Select appropriate tests to investigate ABO/D anomalies and perform them in
accordance with standard laboratory procedures.
Interpret results of tests and controls and distinguish between normal, erroneous and
anomalous results.
Assign appropriate blood groups to patients to ensure safe transfusion practice.
Identify samples requiring additional testing and possible referral.
Complete all relevant documentation in accordance with quality control and audit
requirements.
R
e
nc
e
er
ef
y
op
C
103
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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:
104
R
e
nc
e
er
ef
y
op
C
7.8c Antibody Identification
Be able to select and perform tests to identify red cell antibodies, and interpret results in a
clinical context.
KNOWLEDGE
Understand the basis of the major blood group systems, the characteristics of red cell
antigens within each system and the clinical significance of corresponding antibodies
in pre-transfusion and antenatal scenarios.
Understand the mechanisms of antigen:antibody reactions and their role in in-vivo red
cell destruction.
Understand the principles, practice and application of the range of tests available to
aid antibody identification.
Know how to positively identify antibody specificities using BCSH guidance on
inclusion.
R
Understand how to systematically exclude antibody specificities as part of the
antibody identification process.
e
er
ef
Understand the relevance of red cell phenotyping in antibody identification.
Know how to interpret results, recognise and deal with samples requiring further
investigations.
nc
Know the relevant internal and external quality assurance procedures.
e
Be aware of local policies and procedures and national guidelines covering all of the
above.
You must be able to:
Prepare samples, select reagents and controls.
y
op
C
COMPETENCE
Perform routine antibody identification tests in accordance with standard laboratory
procedures.
Interpret the result of antibody identification, a recognise cases requiring additional
tests and / or clinical advice.
Recognise the likely clinical significance of the antibody specificities identified and
select safe blood components for transfusion.
Complete all relevant documentation in accordance with quality control 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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.8d Red Cell Phenotyping
Be able to perform and interpret results of red cell phenotyping tests.
KNOWLEDGE
Understand the relevance of red cell phenotyping in pre-transfusion and antenatal
testing.
Understand the rationale for extended red cell phenotyping for patients on long term
transfusion support and know which groups of patients may require blood matched for
antigens other than ABO and D.
Know in which situations red cell phenotyping cannot be performed and genotyping is
required.
Understand the selection of reagents and controls for red cell phenotypes.
Understand the requirement for validation of reagents prior to use.
Understand the relevance of antithetical groups when performing red cell phenotypes.
R
Know the relevant internal and external quality assurance procedures.
e
er
ef
Be aware of local policies and procedures and national guidelines covering all of the
above.
You must be able to:
nc
COMPETENCE
e
Recognise situations where phenotyping will not give a reliable result.
C
Prepare samples and select reagents and controls.
op
Perform extended red cell phenotyping in accordance with standard laboratory
procedures.
y
Identify appropriate antithetical and familial antigen groups required for a complete
phenotype.
Interpret results and distinguish between normal, unusual, erroneous and abnormal
results.
Complete all relevant documentation in accordance with quality control and audit
requirements.
Identify samples requiring referral for additional testing.
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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
7.8e Selection of Red Cells and Components
Be able to provide blood components with appropriate specifications to meet patient
transfusion requirements.
KNOWLEDGE
Be aware of the criteria for the selection of donors and the mandatory tests performed
on all donations.
Be aware of extended and additional testing performed on donations for specific
patient categories, e.g. neonates.
Be aware of the principles of blood component preparation, and the range of blood
components available.
Know how to interpret tests and their results from other areas/disciplines of pathology
(e.g. haematology and coagulation) in clinical context to determine transfusion
requirements.
R
Be aware of alternatives to allogeneic blood transfusion.
e
er
ef
Understand the importance of communication with all staff groups involved in
effective provision of transfusion support in routine and emergency situations.
Know the criteria for selection of red cells and components for patients with clinical
conditions giving rise to special requirements e.g. HSCT, IUT, neonates, AIHA, solid
organ transplants, red cell antibodies.
nc
Know the rationale for selection of red cells and components with additional
specifications, e.g. irradiated, CMV negative, HbS negative, K- for females of childbearing potential, phenotyped.
e
Know the relevant internal and external quality assurance procedures.
C
Know the main requirements of national guidelines relating to the above.
op
Be aware of local policies and procedures and national guidelines covering all of the
above.
y
110
COMPETENCE
You must be able to:
Determine what tests are required before issuing blood or components.
Select the appropriate blood component to meet the patient‟s special requirements.
Provide safe and effective blood and components for emergency use.
Provide transfusion support in cases of major haemorrhage, demonstrating the ability
to communicate effectively with all parties involved.
Recognise the potential need for specialist products, e.g. cryoprecipitate, PCC.
Complete all relevant documentation in accordance with quality control and audit
requirements.
Identify cases requiring specialist components, products or clinical advice.
R
e
nc
e
er
ef
y
op
C
111
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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:
112
R
e
nc
e
er
ef
y
op
C
7.8f
Procedures for Establishing Compatibility
Be able to select and undertake appropriate pre-transfusion procedures to ensure the
issue of compatible blood and components to patients.
KNOWLEDGE
Understand the importance of pre-transfusion testing in establishing compatibility.
Understand the value of a historical record in pre-transfusion procedures.
Understand the role of IT and automation in improving security in pre-transfusion
testing.
Know the criteria for suitability of samples for serological crossmatching / electronic
issue, dependent on the patient‟s recent transfusion and obstetric history.
Know the principles and practice of serological compatibility testing.
R
Know the principles and practice of „electronic‟ and remote issue of blood and
components and the criteria for use.
e
er
ef
Know how to investigate an incompatible serological crossmatch.
Know the relevant internal and external quality assurance procedures.
Be aware of local policies and procedures and national guidelines covering all of the
above.
op
C
You must be able to:
e
nc
COMPETENCE
Determine what tests are required before issuing blood or components.
Determine whether patients are suitable for electronic issue.
y
Perform necessary compatibility tests in accordance with standard laboratory
procedures.
Clearly distinguish between normal and abnormal results.
Evaluate requests for further blood components to decide whether additional samples
/ tests are required before issue.
Complete all relevant documentation in accordance with quality control and audit
requirements.
Identify cases where additional testing or clinical advice is required.
114
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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:
115
7.8g Issuing of blood components and products
Be able to prepare, issue and track the fate of blood component and products.
KNOWLEDGE
Know the correct procedures for the labelling and issue of blood components and
products by the transfusion laboratory for patient use.
Know the subsequent storage requirements and expiry times of thawed plasma
products.
Know the relevant
components/products.
storage
and
transport
criteria
for
issued
blood
Know the procedures for traceability, recall, restocking and disposal of blood
components and products.
Be aware of local policies and procedures and national guidelines covering all of the
above.
R
e
er
ef
COMPETENCE
You must be able to:
Prepare FFP and cryoprecipitate for issue.
nc
Visually inspect blood components to ensure they are fit for use.
e
Label and issue blood components/products via IT systems to ensure complete
traceability.
C
Manage requests for further red cells, components or products.
Manage return of unused blood components / products.
op
Complete all relevant documentation in accordance with quality control and audit
requirements.
y
116
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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:
117
7.8h Blood Stocks Management
Be able to manage blood stocks in a hospital setting and understand the principle of
appropriate use.
KNOWLEDGE
Understand the risks associated with inappropriate care and handling of blood
components and products.
Understand the principles of appropriate use of blood and blood components.
Understand the requirement for traceability from donor to patient and vice versa.
Know the role of stock management in the efficient use of blood.
Know of the role of the Blood Stocks Management Scheme [BSMS].
R
Be aware of local policies and procedures and national guidelines covering all of the
above including emergency blood management where national stock levels are
„critical‟.
e
er
ef
COMPETENCE
You must be able to:
nc
Check stocks and place routine orders with blood services in accordance with
standard laboratory procedures.
Order blood and blood components in routine and non-routine situations.
e
Sort and rotate stock to ensure the most efficient use of stocks is achieved.
C
Collect data for the BSMS and act on feedback to minimise wastage.
y
op
118
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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:
119
7.8i
Adverse Reactions and Events in Transfusion
Be able to investigate adverse reactions and events in transfusion and undertake
appropriate internal error reporting.
KNOWLEDGE
Know the classification and characteristics of adverse reactions to transfusion.
Understand the laboratory based procedures for investigating suspected adverse
reactions according to clinical presentation.
Knows the process for internal and external recall
Know the role of internal and external incident reporting [e.g. SABRE / SHOT] in
reducing errors in blood transfusion.
Know the principles and application of root cause analysis.
R
COMPETENCE
e
er
ef
You must be able to:
Respond to reports of suspected adverse reactions / events in accordance with
standard laboratory procedures.
Identify the probable „type‟ of adverse reaction / event.
nc
Identify the samples required and refer for appropriate testing.
e
Complete an internal and/or external recall in accordance with local laboratory
procedures.
C
Perform repeat testing on pre- and post-transfusion samples in cases of suspected
haemolytic transfusion reactions.
Recognise when referral for additional testing is required.
y
op
Interpret results in clinical context.
Complete all relevant documentation in accordance with quality control and audit
requirement including relevant internal and external incident reporting.
Inform the clinical and transfusion specialist staff of the outcome of laboratory
investigation.
Assess the need to report to SHOT and /or SABRE, and for internal SAE reporting.
Take part in root cause analysis if required.
120
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:
R
Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
nc
e
er
ef
Date of completion:
Date of completion:
y
op
Trainer‟s signature:
C
Trainer‟s name:
e
One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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:
121
7.8j
Antenatal Testing and Procedures
Be able to perform routine antenatal testing, follow up of cases with red cell antibodies,
issue anti-D prophylaxis and test for FMH.
KNOWLEDGE
Know the requirements for routine antenatal testing.
Know how to perform and interpret results of antenatal screening for red cell
antibodies.
Know how identify samples requiring further investigation.
Understand clinical significance of red cell antibodies in the context of HDFN.
Know the requirements for antenatal and postnatal follow-up testing where clinically
significant antibodies are detected.
R
Understand the importance of communication in successful management of
pregnancies in women with red cell antibodies.
e
er
ef
Understand the principles and application of anti-D prophylaxis.
Know the principles of acid-elution/staining and flow cytometric methods for
measuring FMH.
nc
Know how to interpret FMH results and instigate appropriate follow up testing.
Know how to determine the dose of anti-D immunoglobulin required.
e
Be aware of local policies and procedures and national guidelines covering all of the
above.
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COMPETENCE
You must be able to:
Perform routine antenatal and postnatal testing.
Identify cases where further investigation or action is required.
Provide appropriate antenatal anti-D prophylaxis as RAADP, and to cover potentially
sensitising events.
Provide appropriate postnatal anti-D prophylaxis as a standard dose and to cover any
identified FMH.
Perform routine FMH testing by acid elution
Decide when samples require referral for additional or specialist testing.
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Communicate with all staff groups involved to ensure delivery of anti-D prophylaxis
and appropriate laboratory follow up of pregnancies where red cell antibodies are
identified.
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Complete all relevant documentation (paper or electronic) in accordance with quality
assurance and audit requirements.
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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:
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Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
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Date of completion:
Date of completion:
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Trainer‟s signature:
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Trainer‟s name:
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One other piece of evidence chosen by the candidate as an example of their fitness
to practice in performing the named procedure.
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:
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7.8k Haemolytic Disease of the Fetus and Newborn
Be able to investigate suspected cases of haemolytic disease of the fetus/newborn and
provide transfusion support.
KNOWLEDGE
Know the aetiology of haemolytic disease of the foetus/newborn (HDFN).
Know the significance of red cell antibodies in HDFN.
Understand the criteria and methods for quantification of antibodies in pregnancy.
Understand the need to differentiate between immune and prophylactic anti-D.
Know the role of paternal testing and foetal genotyping in monitoring HDFN.
Know the routine testing required on neonates and additional testing required when
the mother has red cell antibodies.
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Understand transfusion requirements for the treatment of HDFN.
COMPETENCE
You must be able to:
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Know the criteria for the selection of blood for IUT, exchange and top-up transfusions.
Prepare samples, and select correct reagents and controls for all testing.
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Undertake compatibility testing and provide appropriate blood components / for the
fetus / neonate as IUT, exchange or top up transfusion, in cases of HDFN due to red
cell antibodies.
Perform a DAT on cord blood sample and comment on the significance of the results.
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Complete all relevant documentation (paper or electronic) in accordance with quality
assurance and audit requirements
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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:
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Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
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Date of completion:
Date of completion:
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Trainer‟s signature:
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Trainer‟s name:
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One other piece of evidence chosen by the candidate as an example of their
competence in this area.
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:
127
7.8l
Investigation of Red Cell Autoantibodies
Be able to investigate cases with red cell autoantibodies and provide safe transfusion
support
KNOWLEDGE
Know the main reasons for in vivo sensitisation of red cells with immunoglobulins and
/or complement in autoimmune haemolytic anaemias and post-transplantation.
Know the mechanism of in vivo red cell destruction.
Know the principles and practice of direct antiglobulin techniques using poly- and
mono-specific antiglobulin reagents.
Understand how a positive DAT may influence results of pre-transfusion testing.
Know how to provide blood for patients with autoantibodies.
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Know the relevant internal and external quality procedures.
COMPETENCE
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Know how to interpret results and deal with samples requiring further investigations.
You must be able to:
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Perform a DAT using polyspecific and monospecific reagents.
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Interpret results of tests and controls, and distinguish between normal, erroneous and
anomalous results.
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Identify samples requiring further or additional testing.
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Complete all relevant documentation accurately in accordance with quality control
and audit requirements.
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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:
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Answered questions set by trainer on the principles and practice of named
procedure.
Trainer‟s name:
Trainer‟s signature:
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Date of completion:
Date of completion:
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Trainer‟s signature:
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Trainer‟s name:
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One other piece of evidence chosen by the candidate as an example of their
competence in this area.
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:
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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):
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Personal reflection on training and example of evidence:
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About this document
Document title:
Record of Laboratory Training for the Specialist Diploma in
Haematology with Hospital Transfusion Practice
Produced by:
Haematology and Transfusion Advisory Panels
Contact:
Executive Head of Education on [email protected]
Version:
Edition 3
Date active:
September 2011
Comments:
Copyright and disclaimer
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for any other use of this material. All rights are reserved.
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copyright © Institute of Biomedical Science 2011
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About IBMS Publications
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The Institute publishes a wide range of professional and scientific publications and
guidance. Further information and downloadable publications: www.ibms.org/publications
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About biomedical science
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IBMS vision and purpose.
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Biomedical science is the application of the natural sciences to the study of medicine.
Although relating principally to the causes, consequences, diagnosis and treatment of
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Develop professional standards to guide those who practice biomedical science
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biomedical scientists.
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Represent the interests of biomedical science, provide advice and work with UK
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Provide professional support and benefits for members.
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Develop qualifications, training and diplomas for members to demonstrate levels of
expertise and competency along a career pathway.
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To enable members to achieve their highest potential via continuing professional
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Inform and guide biomedical scientists through media, professional and scientific
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Promote public awareness of biomedical science.
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