Supervisor’s Report
Haematology
Please review the Trainee’s portfolio and logbook before completing this report
Name of Trainee (please print)
RCPA ID no.
RACP ID no
(joint trainees only)
Name of organisation
Year of training
1
2
3
4
5
If >5, please specify
Training period - provide full, accurate
dates for accreditation of training
______/_____/_____ to ___/______/_______
 Full Time or
Specify hours per week employed
 Part Time
Leave (taken or planned within this
training period
Is this a pre-examination report?
 Annual
……..weeks or …….days
 Study leave
……..weeks or …….days
 Sick leave
……..weeks or …….days
 Parental/maternity
……..weeks or …….days
 No
 Yes
Name of supervisor (please print)
Leave taken by supervisor during
this training period
23 Febl 2016
 Part I
 Part II
Supervisor RCPA ID no.
Arrangements made for supervision during period of
supervisor leave
Page 1 of 4
Please inspect the forms in the Trainee’s portfolio and use the Table below to record evidence of
completion
Portfolio items for which there is a minimum requirement
Minimum for Part
I pre-exam
Supervisor’s
report
Minimum for Part
II pre-exam
Supervisor’s
report
DOPS for bone marrow
1 only
Not applicable
DOPS for practical transfusion
serology
1 only
Not applicable
Previous
total
Number in
current year
or rotation
Cumulative
Total
Case-based discussions
RCPA trainees 3
(CbD)
RCPA trainees 2
after Part I
JSAC trainees 3
Laboratory safety checklist
1 only
Not applicable
No minimum
No minimum
4 per year
4 per year
Teaching sessions conducted
No minimum
No minimum
Previous supervisor’s reports
all
all
Not applicable
1 only
Meetings attended
Presentations at meetings
Dissertation proposal
Professional qualities: e-Learning modules
Date completed
Please specify whether RCPA module or workplace training
Cultural competence
Ethics
Management
Quality
For pre-examination supervisor’s reports:
Does the print-out of the portfolio summary spreadsheet accurately record the contents of the portfolio?
Yes
23 Febl 2016
No
Page 2 of 4
Please score the Trainee’s performance using this scale during the current assessment period
1. Performance currently falls far short of expected standards. Trainee requires supervision and frequent
cueing on routine tasks.
2. Performance currently falls short of expected standards.. Trainee requires supervision and some cueing
on routine tasks.
3. Performance is as expected for the level of training. Trainee is able to carry out routine task unaided.
Supervisory input needed for complex tasks.
4. Performance is better than expected for the level of training.
5. Exceptional performance. Able to practise independently and provide supervision to junior trainees.
Very few trainees will fall into this category.
N/A not applicable to this training period
Clinical
haematology
Laboratory
haematology
Microscopy &
flow cytometry
Knowledge base
Ability to inter-relate laboratory and clinical data
Skill at the bench
Understands workflow, sample, specimen processing
Understands method principles
Basic knowledge of statistical processes in the laboratory
Computer skills re automated processes in the laboratory
Ability re morphological descriptions
Ability at histological diagnosis
Knowledge and use of appropriate ancillary techniques
Participation in QA
Participation in trouble shooting
Safe handling and OHS
Consultation skills
Ability to function in a haematology ward and clinic
Research and professional behaviours
Basic organisational skills related to workload, time management, prioritisation of tasks
Computer skills: word processing, slide preparation, retrieval of laboratory data, library retrieval
Keeps orderly records, up-to-date progress notes; completes accurate, succinct, timely reports,
Attends to professional confidentiality, ethical standards, medico-legal obligations
Awareness of own limitations: consults when needs help, receptive to feedback & other views
Interactions with others (peers, seniors, clerical and laboratory staff, supervisor, clinicians)
Knowledge of research methods, including , special techniques
Analysis of published research, including statistical analysis
Ability to prepare a manuscript
Presentations at meetings (eg, grand rounds, clinical meetings)
Involvement in teaching/supervision
23 Febl 2016
Page 3 of 4
Overall evaluation
Areas of strength in professional practice (please summarise)
Areas for development in professional practice (please summarise)
Is specific further professional development required?
If yes, please outline process
Yes
No
If a score of 1 or 2 is given please identify any specific issue that needs to be addressed with
respect to the trainee’s progress and/or the training environment. In this case the form must be
signed by the supervisor plus at least one senior colleague and a plan for remediation
attached.
Other comments (if insufficient space, please attach sheet)
Signatures
Trainee
Date
(please PRINT name and sign)
RCPA Supervisor
Date
(please PRINT name and sign)
Other senior staff member
Date
(please PRINT name and sign)
Head of Department
Date
(please PRINT name and sign)
Comments by trainee:
Signature
Registrar/Deputy Registrar, Board of Censors
23 Febl 2016
Date
Page 4 of 4