Supervisor’s Report for Trainees in General Clinical Pathology
Information for Trainees and Supervisors
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It is the Trainee’s responsibility to ensure that this form is completed and submitted by the due
date. Failure to do so may jeopardise the accreditation of training time or finalisation of
examination results.
At least one Supervisor’s Report is due annually for all Trainees.
For Trainees who participate in rotational programs, one report should be completed for each
period of rotation at a different institution.
For Trainees sitting for Part I or Part II examinations, an additional pre-exam report is due by 15
July. Reports must be available for consideration at the viva examinations.
For all other Trainees, the Report must be submitted every year or, for rotations within a year, on
completion of each rotation. If the Trainee is not taking an examination, the annual Report may
be submitted with the annual registration for the subsequent year.
Trainees are advised to keep accurate records of work undertaken for the period of time spent in
each category of activity. A log book is an effective way in which this can be achieved. If precise
figures are unavailable, a best estimate should be given.
Trainees must keep a copy in their Training Portfolio of each year’s completed report. Please do
not contact the College for the previous year’s report.
Completing the form
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It is desirable that all specialists who supervise Trainees participate in the evaluation process and
completion of the form.
Supervisors are asked to rank the performance in each area of activity even if the time spent in it
is small. If there has been no exposure to a particular activity please write “Not Applicable”
across the space allocated for ranking.
Performance for skills in each area of training listed in the form should be assessed on a sliding
scale of 1 to 5 as indicated below.
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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.
Please return this form by the due date above, by mail to:
The Royal College of Pathologists of Australasia
207 Albion Street
Surry Hills NSW 2010 AUSTRALIA
Faxed reports will not be accepted.
23 February 2016
Thank you
THE ROYAL COLLEGE OF PATHOLOGISTS OF AUSTRALASIA
Supervisor’s Report for Trainees in General Clinical Pathology
Name of Trainee (Please print): _________________________________ RCPA ID No_________
Organisation: _____________________________________________________________
Year of Training:
1
2
3
4
5
6
7
Training Period:
______/______/__________ to ______/______/__________
(Please provide full and accurate dates for accreditation of training)
Full Time  or Part Time  ……………hours per week
Leave (taken or planned within this training period
Annual ……… weeks/days
Other ……… weeks/days (eg. Sick, Study, Parental, Maternity)
Sitting for RCPA examination this year?
No
Yes
(Please tick)
If yes:
Clinical
Morphology
Please see key on Page 1
A.
KNOWLEDGE BASE AND SKILLS in the DISCIPLINE of: _______________________
1. CLINICAL SKILLS
1
1.1
Knowledge of clinical application:
1.2
Consultation skills:
1.3
Ability to inter-relate laboratory and
clinical data:
Ability to function in a clinical situation: ____
2
3
4
5
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1
2
3
4
5
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Understands principles of colorimetry and
its variants, including spectrophotometry
and fluorimetry, polarimetry and electrometry ____ ____
____
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2.3
Understands pH meters and of osmometry
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2.4
Understands workflow, sample
and specimen processing
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Has basic knowledge of statistical
processes in the laboratory
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1.4
2. LABORATORY SKILLS
2.1
2.2
2.5
Understands theory of weights and
measures including balances and micrometers,
volumetric apparatus and centrifuges
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23 February 2016
2.6
Has developed basic management skills
related to his or her workload and
staff interaction
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Has developed adequate computer skills
re automation of the laboratory
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Has developed adequate individual computer
skills re word processing, slide preparation,
retrieval of laboratory data, and library
retrieval skills
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1
2
3
4
5
3.1 Description
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3.2 Ability to set up microscope
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3.3 Knowledge and use of appropriate
Ancillary techniques (eg., special stains,
immunohistochemistry)
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3.4 Follow-up and completion of
assigned task
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2.4
2.5
3.
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MICROSCOPY & INSTRUMENTATION
3.5 Competence in the following:
3.5.1
laboratory organisation and staffing
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3.5.2
laboratory environment and safety
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3.5.3
selection, supervision and
maintenance of equipment
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specimen handling, collection
and transport
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3.5.5
method evaluation
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3.5.6
internal and external quality control
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3.5.7
data handling (from request to report) ____
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3.5.8
documentation of laboratory
procedures
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understanding of limitations and
pitfalls of the testing procedures,
including the statistical aspects
such as sensitivity, specificity and
efficiency of an analytic event
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3.5.4
3.5.9
3.5.10
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work flow procedures
INVESTIGATION OF THE PATIENT
1.
2.
3.
1
2
3
4
5
Understanding of the correct choice of
investigations related to the clinical status
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Can the candidate undertake the proper
interpretation of the results in clinical
context?
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Does the candidate offer useful and
competent advice to the clinician?
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1
2
3
4
5
GENERAL REMARKS
1.
Organisational skills
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2.
Presentation at clinical meetings
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3.
Knowledge of current literature
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4.
Knowledge of laboratory management
and safety, and quality assurance
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5.
Attention to professional confidentiality
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B.
PROFESSIONAL ATTITUDES
1
2
3
4
5
1.
Interactive skills with:
1.1
Peers
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1.2
Supervisors
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1.3
Clerical and laboratory staff
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1.4
Clinicians
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2.
Confidence and initiative
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3.
Reliability
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4.
Ability to follow supervisor instructions
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5.
Does the trainee consult
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appropriately when he or she needs help?
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6.
Is the trainee receptive to new ideas?
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23 February 2016
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Completion of professional qualities e-Learning modules ((please specify whether RCPA
online module or workplace training)
•
•
•
•
C.
Cultural competence
Ethics
Management
Quality
date completed ………….………………………………..
date completed ………….………………………………..
date completed ………….………………………………..
date completed ………….………………………………..
OVERALL EVALUATION
Areas of strength in professional practice
(Please summarise)
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Areas for development in professional practice
(Please summarise)
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Is specific further professional development required?
Yes
No
If yes, please outline process: ___________________________________________
____________________________________________________________________
____________________________________________________________________
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.
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
23 February 2016
OTHER COMMENTS
(if insufficient space, please attach sheet)
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
COMMENTS BY TRAINEE:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Signatures
Trainee
(please PRINT name and sign)
RCPA designated supervisor
(please PRINT name and sign)
Other senior staff member/second Supervisor (if applicable)
(please PRINT name and sign)
Head of Department
(please PRINT name and sign)
Registrar/ Deputy Registrar Board of Censors
23 February 2016
Date
Date
Date
Date
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