Institute of Biomedical Science. Specialist Diploma Reference Portfolio. IBMS Professional Qualifications

Transcription

1 Institute of Biomedical Science Specialist Diploma Reference Portfolio IBMS Professional Qualifications

2 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 External Assessor s Name 3 rd Edition (September 2011)

3 Training Review Reviewed by Date Comments

4 CONTENTS 1. INTRODUCTION CRITERIA FOR USE OF PORTFOLIO LABORATORY BASED TRAINING EXTERNAL ASSESSMENT PROCEDURE FREQUENTLY ASKED QUESTIONS GLOSSARY DISCIPLINE SPECIFIC Primary Investigations of Blood and its Components a Cell Counting and Haemoglobin Concentration Measurement b Erythrocyte Sedimentation Rates (ESR)/Plasma Viscosity c Identification and Enumeration of Peripheral Blood Cells by Microscopy d Infectious Mononucleosis e Sickle Cell f Malaria Parasites g Haemostasis Function h Fibrinogen i Fibrin Degradation Products j Anticoagulant Therapy Iron Deficiency Anaemia and Iron Overload a Iron Deficiency Anaemia and Iron Overload Haemolytic Anaemia a Haemolytic Anaemia Screening Tests b Inherited and Acquired Haemolytic Anaemia Abnormal Haemoglobins and Thalassaemia a Haemoglobin Variants (HbS, C, D, E) b Imbalanced Globin Chain Production c Unstable Haemoglobin Megaloblastic Anaemia a Vitamin B12 Deficiency... 78

5 7.5b Folate Deficiency Haematological Malignancies a White Cell Malignancy b Polycythaemia Haemostasis Abnormalities a Bleeding Disorders b Thrombotic Disorders c Lupus Anticoagulant Hospital Transfusion Practice a Routine ABO/D typing and antibody screening b ABO and RhD Anomalies c Antibody Identification d Red Cell Phenotyping e Selection of Red Cells and Components f Procedures for Establishing Compatibility g Issuing of blood components and products h Blood Stocks Management i Adverse Reactions and Events in Transfusion j Antenatal Testing and Procedures k Haemolytic Disease of the Fetus and Newborn l Investigation of Red Cell Autoantibodies

6 1. INTRODUCTION

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8 1. INTRODUCTION The IBMS has developed the Specialist Portfolio to enable the recognition of structured, standardised post-registration training and assessment of newly registered biomedical scientists. The portfolio enables individuals to provide evidence of training, practical skills, specialist knowledge and competency gained in the two years after registration into the profession. Newly registered individuals have the opportunity to evidence their development of specialist knowledge and competencies in their chosen field by completion of the Institute s Specialist Portfolio. They must, as a minimum requirement, be in the IBMS membership class of Licentiate. The training portfolio is issued on application to the Institute with the required payment, which is inclusive of the end point assessment. Applicants must be working in a laboratory with Institute post registration training approval. The portfolio is not available to Associate members of the Institute or individuals undertaking pre-registration training. Completion of the portfolio and successful assessment will lead to the award of a discipline specific Specialist Diploma. The Specialist Diploma confers eligibility to apply to upgrade Institute membership from the class of Licentiate to Member provided the individual has a minimum of 2 years professional experience as a Licentiate member. In order to be awarded an Institute Specialist Diploma the individual must be a fully paid up corporate member of the Institute for at least one year and have completed the Institute s Specialist Training Portfolio in accordance with the Institute s instructions. The portfolio can be used as evidence to help biomedical scientists seeking career advancement, identifying education and training needs if returning to work or working in new disciplines, or by employers when considering eligibility for promotion. The portfolio can also be used by Higher Education Institutions in assessing work-based learning and accredited learning for postgraduate qualifications. It is recognised that the changes in service delivery and reconfiguration of pathology services is leading to combined disciplines or variations in the scope of practice for individuals within some laboratories. Such is the potential variation that a one size fits all specialist portfolio in blood sciences is not practical. A named discipline specific portfolio therefore reflects the range of analyses performed by most routine laboratories in the UK, although some might not be performed in the candidate s own laboratory. All sections must be completed in order to express the ability of the biomedical scientist to operate at the specialist level. Where a particular analysis is not performed in the candidate s laboratory, knowledge of the principles and practice must still be demonstrated, together with an understanding of the key skills required to perform the test. There may be other tests the training laboratory includes in its basic repertoire and therefore requires the individual to be competent in. These can be assessed and then recorded in the reflective log at the end of each sub-section. 7

9 To support members working in routine service laboratories that reflect a more crossdiscipline requirement for specialist practitioners, provision will be made, following purchase of the most appropriate discipline-specific portfolio, for modules to be substituted with one or more modules from specialist portfolios of other disciplines. The Specialist Diploma award transcript will reflect the main discipline plus altered modules. Requests from laboratory managers wishing to use the specialist portfolios to reflect the test repertoire of their laboratory will be considered upon submission of a written proposal of modules (and rationale for the request) to the Institute s Education Department, ahead of commencement of training. Achievement of the required knowledge and competence of the range of analyses expresses the ability of the biomedical scientist to operate at the specialist level as defined in the learning outcomes below: Learning Outcomes The learning outcomes of the Specialist Diploma are subdivided into the following three areas which candidates must be able to demonstrate they have met through completion of the portfolio and subsequent assessment procedure. Knowledge and understanding a. Demonstrate knowledge of complex scientific and technical aspects of their specialist discipline including: correct procedures for handling specimens before, during and after analysis; maintenance of routine equipment; principles of in-house data management systems and quality control/assurance procedures as evidenced by in-house assessments and laboratory tour. b. Show an awareness of current issues and developments within healthcare and biomedical science as evidenced by presentation and laboratory tour. c. Demonstrate knowledge of the scientific basis of the laboratory tests and the disease process under investigation as demonstrated by in house assessments and tour. Professional skills a. Perform a range of laboratory tests without immediate supervision Demonstrate self-direction in solving problems and exercising personal autonomy in relation to scope of practice as demonstrated by in-house assessments. b. Demonstrate a systematic application of professional knowledge and understanding in interpretation of laboratory data to determine action based on best practice as evidenced by in house assessments and portfolio evidence. Transferable skills a. Demonstrate communication skills within the healthcare environment and as part of the laboratory team as evidenced by presentation. b. Demonstrate the ability to critically reflect in order to inform best practice as evidenced by all aspects of the portfolio. 8

10 During completion of the portfolio, biomedical scientists will be gathering evidence of continuing professional development (CPD) and competence to practice. This meets the fundamental requirements of continuing registration with the HPC, i.e. compliance with the following areas: Professional autonomy and accountability Professional relationships Identification and assessment of health and social care needs Formulation and delivery of plans and strategies for meeting health and social care needs Critical evaluation of the impact of, or response to, the registrant s actions Knowledge, understanding and skills Internal Assessments Each of the standards within the discipline specific section requires the candidate to demonstrate knowledge and competence elements. It is the responsibility of the trainer(s) to ensure that these elements; a) and b) below have been met through internal assessments and filed in a single specialist portfolio ready for external assessment. a. Questions set by trainer Each standard requires the assessment of competence primarily through the answering of questions set by the trainer on the stated subject areas indicated by the knowledge and competence statements for each module. The portfolio is not prescriptive about the type of assessment which may be done via an oral tutorial, written questions or other suitable task. (Please note: Essays are NOT considered a suitable form of assessment). b. Other evidence Although evidence of training and assessment may be generated as part of good laboratory practice only ONE other example of evidence is required for the Evidence of Achievement section. This is chosen by the candidate as an example of evidence that demonstrates their knowledge and competence in performing a particular technique. The choice of evidence is justified in the Reflective log. Other examples of evidence that may be acquired during the course of training can, if the candidate wishes, be filed for reference purposes in a separate portfolio as additional evidence of competence. THIS IS ENTIRELY OPTIONAL AND IS NOT A MANDATORY PART OF THE EXTERNAL ASSESSMENT PROCESS. This may include the recorded observation of practical skills, case studies or other evidence of knowledge acquired during formal study for a postgraduate award or as part of an internal training regime. 9

11 Reference to a range of sample types can include blood, serum, plasma, urine, CSF, other fluids and tissues as appropriate to the routine investigation within the discipline, either as a main discipline (e.g. Haematology or Clinical Biochemistry) or a combination of disciplines (e.g. Blood Sciences). It also includes by inference, the knowledge and competence required to assess the suitability of the sample under investigation, for example lipaemic, inadequate, haemolysed, inappropriately labelled, transported, or stored samples within a specific sample type and for analysis using specific equipment. How to Use This Portfolio A summary of the criteria for using the Specialist Portfolio is contained in Section 2. Further information regarding laboratory training is contained in Section 3. Information about the assessment process is contained in Section 4. Answers to frequently asked questions can be found in Section 5. A glossary of commonly used terms is listed in Section 6. PLEASE NOTE: Whilst the award of a higher degree is not a prerequisite for the award of a Specialist Diploma there is the opportunity to integrate the two where possible. For example, inservice training undertaken to complete this portfolio could be recognised by higher education institutions under the category of work-based learning and accrue academic credit towards an M level qualification. Equally, the formal education and assessments undertaken as part of an MSc degree may support in-house laboratory training for completion of the portfolio. 10

12 2. CRITERIA FOR USE OF PORTFOLIO

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14 2. CRITERIA FOR USE OF PORTFOLIO 2.1 Only the Institute s Specialist Portfolio can be used for the purpose of recording the training of a biomedical scientist for the Institute s award of a Specialist Diploma. 2.2 Specialist portfolio training must take place in a laboratory approved for training by the Institute. 2.3 The Specialist Portfolio will only be issued to a named Institute member upon completion of the application form by the Departmental Training Officer or Manager. 2.4 The portfolio requires specific evidence that indicates that candidates have applied knowledge, comprehension and analytical skills gained at undergraduate level to the (new) situation in which they work as a registered biomedical scientist. 2.5 The portfolio will contain a completed and signed record of laboratory training in the designated speciality, together with a reflective commentary on the learning experience and demonstration of competence. 2.6 Each module contains Knowledge and Competency statements that relate to a laboratory technique or investigative method. 2.7 Requirements for evidence of training and internal assessment of competency are set out in the Evidence of Achievement section of the portfolio. 2.8 The laboratory training officer (or a suitable deputy) and the individual undertaking training must sign and date when the training was completed. 2.9 The candidate must complete the Reflective Log to demonstrate that they can relate knowledge from several areas, draw conclusions and reflect on their own performance as an independent professional learner, thus meeting the requirements for CPD 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. 13

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16 3. LABORATORY BASED TRAINING

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18 3. LABORATORY BASED TRAINING 3.1 To permit eligibility for the award of the Institute s Specialist Diploma in a named discipline(s), the in-service training and assessment must demonstrate sufficient good scientific practice, based on the knowledge and competence in the stated procedures, to meet the requirements of the external assessment process. 3.2 Suitable training can be obtained only by working in a laboratory approved by the Institute. Several trainers may be involved and it is essential that all training is coordinated and carried out under the control of a designated training co-ordinator or training officer. 3.3 A training programme should be prepared and adhered to in accordance with the Institute s Clinical Laboratory Standards for Pre and Post Registration Training of Biomedical Scientists. 3.4 The training co-ordinator/officer should ensure that regular reports on progress from trainers are reviewed at least once a month, discussed with the individual being trained, and documented in the portfolio. The object of these review pages is to ensure that a constructive, detailed, and contemporaneous record is kept, on which future training activities can be based. 3.5 Competence must be achieved by coverage of all modules within the chosen disciplines. Some tests may be considered as core and require demonstration of practical competence. If an investigation were considered to be outside the core repertoire of a routine laboratory, the tests only requires demonstration of knowledge and understanding that would be applied to the practical situation. 3.6 Short periods of secondment to other Institute approved laboratories may supplement training in order for the individual to gain additional practical skills and experience. 3.7 Candidates and trainers may undertake a selection of the following activities to complete training and assess the application of knowledge and skills, i.e. the assessment of competence. i) Work-based training with direct observation of practical skills (DOPS); ii) iii) iv) Case based discussion to demonstrate knowledge of output of work; Self-directed reading to broaden knowledge; 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. 3.8 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. 17

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20 4. EXTERNAL ASSESSMENT PROCEDURE

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22 4. EXTERNAL ASSESSMENT PROCEDURE 4.1 On completion of training in accordance with the requirements of the Specialist Portfolio, the candidate s employer (laboratory manager or training officer) should apply to the Institute for the appointment of a visiting external assessor. The appointed external assessor will be instructed to contact the laboratory to arrange a mutually acceptable date and time for the assessment visit. Documentation guiding the assessment visit will be sent by the Institute to both the assessor and the training laboratory. 4.2 The aims of the assessment procedure are to: Independently verify that competence has been met (portfolio) and assess the standard of the candidate for suitability for the award of a Specialist Diploma (presentation and laboratory tour); Ensure consistency between disciplines and between laboratories; Check that professional body guidelines and criteria are applied nationally; Reassure the employer that their training is to the appropriate standard; Disseminate areas of good practice; Provide constructive feedback on areas of unsatisfactory practice. 4.3 Role of the External Assessor appointed by the Institute The external assessor for Specialist Portfolios undertakes the dual role of verifier and assessor/examiner. This individual reviews the portfolio to verify appropriate training has been given and completed, and then assesses the candidate through their oral presentation and during the laboratory tour to determine their suitability for the award of the Specialist Diploma. It is not the role of the external assessor to assess the competence of the candidate. This is the responsibility of the trainer, the evidence of which is exemplified in the portfolio. The Institute s role is to verify this has taken place (by checking the portfolio for evidence of training and assessment of competence) and also assess the ability of the candidate to demonstrate an understanding of the scientific basis for tests, quality control, quality assurance, quality management, health and safety and use of equipment commensurate with the learning outcomes in the portfolio. The Institute s representative will also make an assessment on whether or not the laboratory is complying with IBMS standards for approval of the laboratory for training. 21

23 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 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 minute presentation will contain the following elements: An indication of the candidate s scope of practice and how it has developed since registration based on the reflective practice elements of the portfolio; Current developments in the laboratory or recent trends; Special interests or professional activities of the individual. Presentations need not be overcomplicated, should be structured to reflect the areas in which experience has been gained and act as a prompt for the dialogue, which supports the work done in the specialist portfolio. The candidate s presentation skills are not being tested so notes are acceptable but not encouraged. They should only be used to support the PowerPoint presentation slides. The external assessor may wish to ask some questions related to the presentation or seek points of clarification. Stage 2: Portfolio Assessment (Indicative time 60 mins) Assessors should aim to review the portfolio in one hour, which is sufficient to look at evidence contained in a single lever arch file. More evidence than this is deemed as excessive although assessors should not use this as a sole reason to fail to the candidate. It is acceptable for the external assessor to check with the laboratory before the visit that evidence is limited to one file, and if not, request that it is. There should be a signed statement from the laboratory manager testifying to the range of laboratory investigations undertaken by the candidate. (see Section 2: Use of the Portfolio, paragraph 2.5). This can be used by the external assessor to guide the areas for questioning during the laboratory tour. It is acceptable for external assessors to request this prior to the visit when they finalise arrangements with the laboratory. 22

24 Evidence in the portfolio is prescribed in the EVIDENCE OF ACHIEVEMENT section and this is the ONLY evidence that is required. Evidence should be indexed in the same order as the Specialist Portfolio modules. Additional (optional) supporting evidence of training may be provided in a separate portfolio and referred to if required. The Evidence of Achievement section has three standard requirements: observed by trainer to carry out a specific function/investigation (signature as evidence); answered questions set by trainer (single piece of evidence to demonstrate this); single piece of evidence chosen by candidate (not the trainer) to reflect an aspect of the training. The signed assessment of practice does not require a separate witness statement (unlike the Registration Portfolio). Questions asked by the trainer are informed by the knowledge component and competence requirements of each module. Evidence should support the fact that candidates understand their role and are competent to perform the work, either through questions they have been asked, set (and marked) questions or notes from tutorials. Evidence must be dated and signed by the candidate/training officer as appropriate. The third piece of evidence is selected by the candidate and chosen to demonstrate an aspect of the training and competency assessment. This choice is briefly justified in the Reflective Log, (e.g. as my third piece of evidence I chose to annotate a laboratory printout of results from a test I performed because ). Following the EVIDENCE OF ACHIEVEMENT section the Institute s portfolios must be signed by the internal person who has checked that the requirements for evidence for the module have been completed. The reflective logs are intended to demonstrate that the candidate has developed in the application of their practice and can apply what they have learned in the context of the module. The external assessor will review these reflective reports which should be supported by the evidence contained in the portfolio. This may lead to further discussion on the laboratory tour. 23

25 Stage 3: Laboratory Tour (Maximum 60 mins) The tour should not exceed 60 mins which is considered to be sufficient time to examine the candidate s knowledge, even in a large department. The candidate should be able to respond to questions asked by the external assessor based on the knowledge components of the portfolio and their scope of practice. The candidate should be able to demonstrate they have knowledge of the underlying principles and practice of laboratory investigations they have performed and the equipment they use. If the candidate is involved in training it is reasonable to expect them to explain how they do this. They should be able to explain NEQAS results, and demonstrate that they know how to apply health and safety. In doing so they demonstrate (in conjunction with their presentation and portfolio of evidence) that they meet the learning outcomes detailed in the introductory section of the portfolio. Stage 4: Approval of laboratory for Specialist Training The Institute has published guidance and criteria for approval of laboratories for pre and post registration training. Based on these criteria the laboratory tour also gives the external assessor an opportunity to judge that the laboratory has the appropriate requirements for training against the following checklist. This is provided as separate documentation and is available on the Institute s website. Stage 5: Feedback Comments to Trainer and Candidates. At the end of the assessment process the external assessor informs the candidate and training officer whether they will be making a recommendation (in their report to the IBMS) that the candidate was successful or unsuccessful, and whether or not a recommendation will be made regarding continued approval of the laboratory for training. This also provides an opportunity to seek further clarification on points of evidence if required. Feedback should be concise, constructive and based on the Institute s guidance for assessors, trainers and candidates in relation to specialist portfolio training and completion. Personal opinions or advice may be offered in the context of examples of good practice, but it should be clear they are NOT a specific requirement of the Institute. Stage 6: Completion of Reports Both the external assessor and the laboratory trainer are required to submit reports to the Institute and send a copy to each other. This provides an opportunity to share the feedback, and reflect on this. 24

26 5. FREQUENTLY ASKED QUESTIONS

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28 5. FREQUENTLY ASKED QUESTIONS Eligibility I am not a member of the Institute. Can I complete the specialist portfolio? No. A candidate must have current corporate membership of the Institute of Biomedical Science. Corporate classes are Licentiate, Member, or Fellow. Associate members are not eligible. Why do I need to complete the specialist portfolio? Holding a Specialist Diploma is part of the criteria for upgrading your class of Institute membership from Licentiate to Member. It also demonstrates that you have been assessed against a benchmark standard for a specialist practitioner in your chosen discipline. It is therefore different from the registration portfolio required for HPC registration which is used to evidence that an individual has met a threshold standard of fitness to practise which is profession-specific, rather than based solely on a single discipline. The charge by the Institute for the specialist portfolio is 125. Who should pay? This is a local decision. Both the employer and individual benefit from the opportunity provided by the professional body to facilitate, evidence, and formally recognise the acquisition of specialist skills and knowledge. The charge is a nominal one-off amount towards providing this service to Institute members, and will also cover external assessor expenses for the endpoint assessment. When can my portfolio be assessed? You are required to be a corporate member of the Institute for a minimum of one year before a specialist portfolio can be externally assessed by the Institute. How long will it take for a date to be set for my assessment? This is dependent on the availability of an external assessor. It could be up to two months from receipt of your application form. Please apply well in advance of your preferred date in order for the Institute to organise an external assessor. Portfolio Organisation and Evidence When I completed the registration portfolio I was required to have one file of evidence. Must I approach the specialist portfolio in a similar way? Does it involve as much work or do I simply fill in the portfolio? The principles applied to the registration portfolio also apply to the specialist portfolio. Evidence required for both should not exceed one lever-arch file. Much information has been published in The Biomedical Scientist and in sections of this portfolio. Can you provide advice on how to present, organise and complete the specialist portfolio? There should be an index and the evidence should be organised to match the sections of the portfolio. 27

29 What evidence do I need? The type of evidence is indicated by the Evidence of Achievement section, and this is the ONLY evidence required. It must of course be relevant to the knowledge and competence statements. In order to sign off some of the sections it says "answered questions set by trainer..." (on a particular subject). Does this mean that there is no point getting other evidence for this, and that the only evidence required are some questions I have answered? Also I have several pieces of evidence for some sections but haven't yet been given any questions to answer from my trainer, so I m guessing this section cannot be signed off until I ve done them? The requirements for the evidence of achievement sections are clearly stated. All of them have "questions set by trainer". It is essential that your trainer conducts an assessment exercise that tests your knowledge as applied to the particular techniques - this is the purpose of the "questions asked by trainer". Once completed and you have evidence of this the trainer can sign off this part of the portfolio. Can I use evidence from a laboratory I worked in before I started my SP? I used to work in a reference lab and have copies of published papers with my name on which cover techniques in the SP but not done in my current laboratory. Obviously my trainer couldn't sign to say they'd witnessed my practical skills, but would that be ok to cover the principles? The requirements for the evidence of achievement sections are clearly stated and do not include copies of published papers. (You could put these in your professional portfolio). Who signs? The Evidence of Achievement section requires the trainers name and signature, and therefore should be signed by the person who assesses competence at the end of the relevant training. Underneath is an area in which to confirm the section has been completed and the evidence assessed and checked internally (e.g. by the training officer). In some instances this will be the same person. Is the person who signs the person who actually trained you in that technique, or does it have to be the training officer? Is it okay for a BMS1 to sign (if they did the training) or does it have to be a more senior person? I have a very "reluctant" training officer! Someone in the laboratory who has assessed your competence should provide the signature for the portfolio. As long as they are competent to train and assess you, the grade of staff should not be an issue. However, the training officer (or someone senior) should take responsibility for assessing the evidence is appropriate for each section and sign the section underneath the Evidence of Achievement section. You may wish to discuss these points with your trainer and perhaps with them also review the guidance on the IBMS website. It may also be helpful to clarify the role of your training officer with your line manager if they are "reluctant" as this may affect the training status of the laboratory if there is inappropriate support for training. 28

30 How do I complete the Reflective Logs at the end of each section? The aim of this part of the portfolio is to encourage you to think about your experience and how you can apply your skills in other areas. Try to capture what the laboratory does in relation to the topic, what you have learned, and how you apply this in the context of patient diagnosis. Future learning is identified by how you wish to build on this experience. It is very much an expression of your personal experience. Training and Standards I have been working as a trainee biomedical scientist, then as a BMS1 for almost two years in a specialist laboratory (four years in total), but only applied for my specialist diploma book after changing my job and starting an MSc. Should the date of my specialist training be when I became registered with the Health Professions Council (HPC) or when I received my book? It is normal for a newly registered practitioner to commence a period of specialist training in order to consolidate and extend their skills and knowledge in their specialist discipline. Therefore you may have accumulated evidence suitable for your portfolio in advance of receiving it. Can I use anything I sent for assessment for my MSc, as I completed this while HPC-registered for the past two years? It may support you training but evidence should be specific to your training and assessment in the laboratory. Do I need to complete all sections of the portfolio? Yes. However, not all sections require evidence of practical competence (it may state Be able to describe...'). Similarly, some skills may be transferable such that, together with knowledge, competence in some techniques may be considered to be achievable, even if the laboratory does not perform the method routinely. How long does training take? Although training can be expected to take up to two years after registration, it may be possible to complete the portfolio in less time if an individual has previous relevant experience to build upon for their specialist training (e.g. experienced gained in a single discipline while on a 12-month university placement). As a training officer I have just received a specialist portfolio for a member of staff. How best should I proceed? There can be no substitute for careful reading of the introductory sections of the portfolios, relevant articles in The Biomedical Scientist and the Education and Careers/Specialist Portfolios section of the IBMS website. You may also wish to contact training officers in other departments to share ideas and good practice so that you fully understand what is required. It is important that you develop a training programme. This can be based on the old 'logbook', but should, of course, be geared to the specialist portfolio. The crux of the qualification is the ability of the individual to articulate knowledge relevant to their specialist practice (e.g. training junior staff). 29

31 The portfolio says: "Answered questions set by the trainer". What questions do I set? Questions must relate to the knowledge and competence sections and are informed by your own professional working knowledge of the principles and application of the techniques. The level of knowledge should reflect that required of a specialist practitioner (see Learning Outcomes in the introductory section). Questions may be verbal during a tutorial session (if so, keep a record of them), written short questions and answers or multiple-choice exercises. The format is at the discretion of the individual trainer and will depend on local circumstances. Are there any courses available to support completion of the specialist portfolio? No specific courses are run by the IBMS, although you may wish to contact your local IBMS branch or university to see if anything is available or can be arranged. Some universities have developed MSc courses with work-based modules linked to the specialist portfolio. Do I need to complete my training in one laboratory? No. There is no requirement to complete in one laboratory and in some cases it may be desirable to have a secondment to another laboratory for some modules. However, the laboratory must be approved by the Institute for training. Specialist Practitioner Status Do I need the specialist diploma to advance my career? Although the Institute's qualifications are not mandatory for professional advancement, they do provide a mechanism by which the employer can measure someone's competence to practise at a higher level. When can I do on-call? When your employer (and yourself) believes you are competent. Ability to do on-call is defined by the employer and depends on the scope of practice required to perform an outof-hours laboratory service competently to the required standard. As with the registration portfolio, the specialist diploma in not linked explicitly to on-call (although it might link to certain elements). I am changing disciplines. Do I need to undertake a second specialist portfolio? Not necessarily. There is no requirement to complete a second specialist portfolio; however, there is a requirement under HPC regulation to be competent in one s scope of practice, and the specialist portfolio is one way you can gain this competence and evidence it. This could also be guided by the requirements of the knowledge and skills framework (KSF). I work in a Blood Sciences department. Which Specialist Portfolio should I apply for? Your laboratory manager must apply on your behalf for the most appropriate disciplinespecific portfolio that represents the bulk of your scope of practice (i.e. test repertoire). Modules can be substituted with one or more modules from specialist portfolios of other disciplines. The Specialist Diploma award transcript will reflect the main discipline plus altered modules. 30

32 6. GLOSSARY

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34 6. GLOSSARY The following terminology is used throughout the portfolio. BE AWARE OF A general appreciation of the content of the key task. KNOW UNDERSTAND A working knowledge (can describe) of the facts associated with the key task. Thorough comprehension (can explain) of the principles and concepts of the content of the key task. COMPETENT Has the ability to perform a test, procedure or area of practice to a set standard on more than one occasion, in a consistent manner and with minimal or no supervision, together with a thorough comprehension of the principles and concepts of the content of the key task. The Institute s Specialist Diploma will only be awarded if there is supporting evidence (as indicated in the portfolio s Evidence of Achievement section) that competence has been achieved. This evidence will be presented as a portfolio, logically and cross-referenced to the relevant module or sections it supports. Suggested examples of evidence: EVIDENCE OF ACHIEVEMENT Audit trail results Annotated photomicrographs Annotated copies of QC/EQA records Tutorial notes for question and answer sessions PowerPoint presentations by the candidate Training records Witness testimonies Assessment logs (must clearly indicated level of knowledge and skill achieved) 33

35 CPA Clinical Pathology Accreditation HPC Health Professions Council SOP Standard Operating Procedure. SoP Health Professions Council Standards of Proficiency. 34

36 7. DISCIPLINE SPECIFIC

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38 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. 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. 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. 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. 37

39 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: o o o o Leucocytes; Erythrocytes; Platelets; Reticulocytes; o White cell differentials. 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. 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. Be aware of the limitations of tests and further investigations that may be required. Know the relevant internal and external quality assurance procedures. 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. 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

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. Answered questions set by trainer on the principles and practice of named procedure. 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

41 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. 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. Perform named test in accordance with standard laboratory procedure. Identify abnormal results and likely significance to clinical detail. Complete all relevant documentation in accordance with quality control and audit requirements. 40

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. Answered questions set by trainer on the principles and practice of named procedure. 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

43 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. 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. COMPETENCE You must be able to: Prepare and stain blood films of suitable quality for morphological analysis. Set up microscope for viewing blood film. Accurately identify morphological features of normal and abnormal cells. 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

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. Answered questions set by trainer on the principles and practice of named procedure. 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

45 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 You must be able to: 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. 44

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. Answered questions set by trainer on the principles and practice of named procedure. 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

47 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: Prepare sample and 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. Describe local clinical procedures to follow up positive or negative results. 46