Supervisor’s Report for
Microbiology
Please review the Trainee’s workplace-based assessment and Portfolio 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
Specify time spent in laboratory (average)
Leave (taken or planned within this
training period
Sitting RCPA examination this
year?
Name of supervisor (please print)
Leave taken by supervisor during
this training period ___ weeks
23 February 2016
 Annual
……..weeks or …….days
 Study leave
……..weeks or …….days
 Sick leave
……..weeks or …….days
 Parental/maternity
……..weeks or …….days
 No
 Yes
Only required for Part II examinations
Supervisor RCPA ID no.
Arrangements made for supervision during period of
supervisor leave
Page 1 of 4
Please score the Trainee’s performance using this scale
1= Performance currently falls far short of expected standards for level of training. There is a
serious problem that may have implications for accreditation of the current training period. The
problem must be stated clearly on the final page.
2 = Performance currently falls short of expected standards for level of training. There is an area of
lower than expected performance. The problem must be stated clearly on the final page.
3 = Performance is consistent with the expected level of training.
About 80% of trainees will merit this grade.
4 = Performance is better than expected for level of training.
About 10% of trainees will merit this grade.
5 = Performance is exceptional.
Very few trainees will merit this grade.
Item
Score
(1-5)
Clinical and laboratory judgment
Able to use up-to-date medical knowledge to select and perform appropriate
investigations
Able to critically assess information, identify major issues, make timely decisions and
act upon them
Able to make appropriate diagnostic and therapeutic recommendations
Able to initiates and evaluate quality management strategies
Professional attitudes and behaviours
Able to organise work, manage time, prioritise, follow up, complete tasks
Completes succinct, accurate and timely reports; communicates with referring
practitioner
Awareness of own limitations - consults when needs help, receptive to feedback &
other views
Attention to professional confidentiality, ethical standards, medico-legal obligations
Interactions with others (peers, seniors, clerical and laboratory staff, supervisor,
clinicians)
Presentations at clinical meetings, eg. grand rounds, clinical meetings
Shows a resourceful attitude towards continuing education to enhance clinical practice
Ability to understand scientific methodology, formulate and test hypotheses and analyse
the results of research studies
Able to critically analyse current literature
23 February 2016
Page 2 of 4
Please inspect the forms in the Trainee’s portfolio and tick the box to indicate completion of
requirements
Annual requirements
 At least 4 per year satisfactory DOPS forms
for different types of procedure, until minimum
required to sit Part I or Part II have been
completed
 At least 2 per year satisfactory CbD forms for
different types of cases until minimum required
to sit Part I or Part II have been completed.
 At least 3 per year different Category 2
Portfolio activities
 At least 3 per year different Category 3
Portfolio activities
 At least 2 per year different Category 4
Portfolio activities
 At least 1 per year Category 5 Portfolio
activity
 At least 2 per year different Category 6
Portfolio activities
 At least 1 per year Category 7 Portfolio
activity
 2 significant incident analysis reports
Additional Year 1 requirements
 Completed personal safety checklist
Additional requirements before sitting Part I
examination
 Achieved satisfactory grade for 9 general
microbiology bench DOPS forms
 Achieved satisfactory grade for 5 CbD forms
(low-to-medium level of complexity)
Additional requirements before sitting Part II
examination
 Has completed major research project
 Has completed minor research project
 Achieved satisfactory grade for 4 special
bench DOPS
 Achieved satisfactory grade for 2 complex
CbD forms per year since Part I exam
Additional requirements when starting work
in a new laboratory
 Participated in the laboratory orientation
Professional qualities: e-Learning modules
Cultural competence
Date completed
Please specify whether RCPA module or workplace training
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
No
23 February 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 a plan
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)
Comments by trainee:
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)
Registrar/Deputy Registrar, Board of Censors
23 February 2016
Date
Page 4 of 4