Laboratory Training Program Milestones Training Milestones_071415_Final.pdf · Laboratory Training...
Transcript of Laboratory Training Program Milestones Training Milestones_071415_Final.pdf · Laboratory Training...
Laboratory Training Program Milestones
In 2012, the Association of Professors of Human and Medical Genetics (APHMG) Laboratory Fellowship Program Directors' Special Interest Group (SIG) established a working group* to create Milestones for laboratory-based training, in order to provide a uniform training framework as well as a tool for trainee evaluation applicable across all laboratory specialties. The working group developed these milestones with input from SIG members, representatives of the Accreditation Council for Graduate Medical Education (ACGME), and a group of recent graduates. The final document was accepted by the ABMGG Board of Directors (BOD) in October 2015, and is a required component of ABMGG-accredited training evaluations beginning in July 2016.
The ABMGG Laboratory Training Milestones (“Milestones”) define performance levels for the skills, knowledge, and behaviors across the ACGME’s six competency domains: Patient Care, Medical Knowledge, Practice-Based Learning, Professionalism, System-Based Practice, and Interpersonal and Communication Skills. The purpose of evaluating trainees’ progress on the Milestones is threefold: to support the educational process; to provide evidence of accountability to the Public, the ABMGG, the program, and the trainees; and to demonstrate that each graduate is competent in the skills necessary to succeed in the Medical Genetics and Genomics specialty(ies) in which they train.
The Milestones should be incorporated into each program’s existing evaluation processes and used at regular intervals for each trainee. The Milestones are only one component of the overall evaluation process, and should not be considered the sole measure of progress and competency.
*The ABMGG is grateful to the Laboratory Fellowship Program Directors SIG Working Group:Drs. Tena Cherry, Tina Cowan, Linda Jeng (chair), and Rhona Schreck, for their work in developing the Milestones.
American Board of Medical Genetics and Genomics Laboratory Training Program Milestones
1
Trainee Name: Program Director Name:
Specialty: Evaluation Date:
Dates in Training: Program Name:
Performs Laboratory Testing – Patient Care
Level 1 Level 2 Level 3 Level 4 Level 5
Identifies the general purpose and principles of clinical laboratory tests (eg. as they differ from research testing)
Describes the elements of a Standard Operating Procedure (SOP)
Explains pre-analytic, analytic, and post-analytic components of testing
Identifies limitations of testing methods
Describes clinical indications for testing
Identifies sources of assay failure
Identifies inappropriate test requests
Selects the appropriate methodology or target for testing
Assesses the elements of test validation
Demonstrates the ability to perform testing independently
Identifies and corrects sources of assay and equipment failure
Develops and validates a new test
Additional Feedback:
American Board of Medical Genetics and Genomics Laboratory Training Program Milestones
2
Evaluates Laboratory Data – Patient Care
Level 1 Level 2 Level 3 Level 4 Level 5
Outlines steps of data collection
Evaluates raw laboratory data with supervision
Identifies when an assay has failed
Evaluates acceptability of quality control (QC)
Defines the purpose and utility for quality controls
Applies reference ranges to the interpretation of a result
Analyzes and interprets raw laboratory data with minimal assistance
Describes normal variability of results
Identifies findings that require further testing
Analyzes and interprets raw laboratory data independently
Takes appropriate steps when a QC failure occurs
Where appropriate, uses statistical data to evaluate results
Establishes QC criteria
Additional Feedback:
American Board of Medical Genetics and Genomics Laboratory Training Program Milestones
3
Interprets the Clinical Significance – Patient Care
Level 1 Level 2 Level 3 Level 4 Level 5
Acknowledges the importance of clinical history in interpreting laboratory results
Defines abnormal and polymorphism/benign findings
Uses medical resources to assess the significance of a novel variant or finding
Classifies findings that are outside of the normal range
Assembles a relevant clinical history
Develops a list of expected abnormalities based on clinical history
Recognizes a result constituting a potential emergency
Utilizes relevant clinical history when interpreting laboratory results
Interprets finding as abnormal or polymorphism/benign
Develops a list of possibilities compatible with an abnormal laboratory result
Applies knowledge of test limitations in formulating an accurate laboratory report
Correlates test results with the clinical history
Proposes additional testing based on test result and/or patient history
Develops functional assay to determine the clinical significance of a novel finding
Additional Feedback:
American Board of Medical Genetics and Genomics Laboratory Training Program Milestones
4
Prepares Written Reports – Patient Care
Level 1 Level 2 Level 3 Level 4 Level 5
Identifies the elements of laboratory reports
Composes a complete normal result report
Drafts a written report for an abnormal result
Describes the process of report transmission
Uses proper language, terminology and nomenclature in reports
Describes the process of amending reports
Composes an abnormal result report for a well- known condition
Independently composes concise, clear written reports
Composes a report with findings of unknown significance
Mentors others in the development of complete and concise reports
Additional Feedback:
American Board of Medical Genetics and Genomics Laboratory Training Program Milestones
5
Applies General Principles of Biology, Medicine, Genetics and Genomics to Laboratory Medicine – Medical Knowledge
Level 1 Level 2 Level 3 Level 4 Level 5
Describes basic principles of genetics and inheritance
Describes the basic scientific principles genetic and genomic tests
Defines relevant medical terminology
Identifies classic genetic syndromes
Identifies key clinical features of patients undergoing biochemical, cytogenetic and molecular testing
Interprets relevant components of a medical chart
Explains relevant disease mechanisms
Articulates principles of relevant therapeutic approaches
Utilizes principles of medicine and biology to identify appropriate testing
Characterizes a new disease, syndrome or gene
Additional Feedback:
American Board of Medical Genetics and Genomics Laboratory Training Program Milestones
6
Applies Specialty-Specific Principles of Clinical and Laboratory Medicine to Patient Care – Medical Knowledge
Level 1 Level 2 Level 3 Level 4 Level 5
Describes basic elements of laboratory safety
Communicates basic principles of biochemical genetics, cytogenetics and/or molecular genetics
Identifies available databases and other online resources relevant to specialty
Describes the techniques of laboratory testing including strengths and limitations
Recognizes major disease categories and testing approaches
Uses SOPs to perform laboratory testing
Identifies key laboratory and clinical features of relevant diseases
Compares elements of laboratory quality control and quality assurance
Utilizes appropriate databases and other online resources
Composes an SOP for a new procedure
Implements a new laboratory methodology
Additional Feedback:
American Board of Medical Genetics and Genomics Laboratory Training Program Milestones
7
Engages in Self-Directed Learning – Practice Based Learning
Level 1 Level 2 Level 3 Level 4 Level 5
Identifies available educational resources
Identifies strengths, deficiencies, and limits in one’s knowledge and expertise
Demonstrates computer literacy and basic computer skills
Formulates an improvement plan based on feedback
Uses information technology to optimize learning
Critically reads and interprets scientific literature
Identifies and performs appropriate learning activities
Critically evaluates and integrates information from diverse sources
Corrects deficiencies proactively
Identifies self-directed goals independently
Participates in national advisory committees
Develops nationally recognized materials and approaches for education of others
Additional Feedback:
American Board of Medical Genetics and Genomics Laboratory Training Program Milestones
8
Gives and Receives Feedback – Professionalism
Level 1 Level 2 Level 3 Level 4 Level 5
Receives feedback constructively
Completes program evaluations
Modifies practice in response to feedback
Provides constructive feedback to trainee mentors
Improves performance based on feedback
Encourages and actively seeks feedback to improve performance
Models exemplary behavior when giving and receiving feedback
Additional Feedback:
American Board of Medical Genetics and Genomics Laboratory Training Program Milestones
9
Demonstrates Accountability and Integrity – Professionalism
Level 1 Level 2 Level 3 Level 4 Level 5
Shows awareness of laboratory testing turnaround times
Adheres to professional responsibilities
Respects assigned schedules
Completes assigned tasks in a timely manner
Assists team members when requested
Acknowledges personal errors
Demonstrates accountability with all members of the health care team
Identifies, communicates and corrects errors
Shows sensitivity to the needs of the patient in the timeliness of overall testing process
Anticipates team needs and takes leadership role to independently implement solutions
Acts as a mentor to others
Exemplifies effective management of multiple competing tasks, with reliable follow-up
Additional Feedback:
American Board of Medical Genetics and Genomics Laboratory Training Program Milestones
10
Appreciates the Laboratory as Part of the Larger Health Care System – System-Based Practice
Level 1 Level 2 Level 3 Level 4 Level 5
Shows awareness of governmental agencies regulating laboratory testing
Recognizes the role of HIPAA in patient care
Shows awareness of the requirements for institutional human subjects research
Recognizes test cost, test benefit, and effect on patient management
Uses EMR/LIS effectively
Demonstrates familiarity with CPT codes and test pricing
Evaluates quality and proficiency testing results
Constructs an appropriate cost benefit analysis or return on investment (ROI) analysis
Evaluates laboratory compliance with federal and state regulatory standards
Shows awareness of reimbursement issues
Participates in writing national guidelines or consensus statements
Formulates system policy regarding test utilization
Participates in local or national professional committees
Additional Feedback:
American Board of Medical Genetics and Genomics Laboratory Training Program Milestones
11
Practices Effective Communication with Colleagues, Patients and Families – Interpersonal and Communication skills
Level 1 Level 2 Level 3 Level 4 Level 5
Shows awareness of the importance of communication between all members of the health care team (including laboratory)
Participates in providing oral communication
Communicates results accurately with minimal supervision
Explains results clearly to appropriate individuals independently (eg. patient and/or family members)
Provides accurate consultation to providers regarding laboratory testing
Mentors others in communicating sensitive results to patients and families
Additional Feedback:
American Board of Medical Genetics and Genomics Laboratory Training Program Milestones
12
Functions and Cooperates Within the Health Care Team – Interpersonal and Communication Skills
Level 1 Level 2 Level 3 Level 4 Level 5
Shows respect for all members of the team
Provides timely communication with laboratory staff
Actively participates as a member of the health care team (eg. patient rounds, clinic conferences, tumor boards)
Uses good written and oral communication skills with other members of the health care team
Assists other members of the health care team to optimize patient care
Leads an inter-professional team (e.g., Safety Committee, Hospital QI Committee)
Program Director Signature: _________________________________________________ Date: _________________________________
Program Director Name: _________________________________________________ (Please Print)
Additional Feedback:
Trainee Signature: _________________________________________________ Date: _________________________________
Trainee Name: _________________________________________________ (Please Print)