american college of veterinary pathologists 2016 …...proficiency in laboratory and quality...

AMERICANCOLLEGEOFVETERINARYPATHOLOGISTS2016JOBTASKANALYSISFORCLINICALPATHOLOGY

ExecutiveSummaryThisdocumentdescribestheJobTaskAnalysis(JTA)conductedforDiplomatesoftheAmericanCollegeofVeterinaryPathologists(ACVP)inaccordancewiththerequirementsoftheAmericanBoardofVeterinarySpecialtiesandconsistentwithbestpracticesfororganizationsthatadministerhighstakesexaminations.TheJTAwascomposedofthreephases:Invention,RefinementandValidation.TheInventionPhasewasconductedbytheextendedACVPCertifyingExaminationBoard(CEB)composedof11coremembersappointedbyCounciland9adhocmembersrepresentingACVPcommitteesandappointedpositionswithCertifyingExamination(CE)relatedresponsibilities.TheobjectiveofthisphasewastoproduceadraftJTAdocumentforsubsequentlevelsofbroaderreview.IntheRefinementPhase,twopanels,oneforanatomicpathology(20members)andoneforclinicalpathology(14members)andrepresentativeofthedemographicsoftheCollege,reviewedthedraftdocumentsandprovidedfeedbacktotheCEBforrefinementconsideration.IntheValidationPhase,theACVPmembershipwasaskedtoparticipateinanon-linesurveyaskingfora1-3or4levelagreementforeachJTAdrafttask.Memberswerealsoaskedtoprovidereasonsfordisagreements.FeedbackfromthesurveywasusedtovalidatetheconclusionsofthefirsttwophasesoftheJTAandtofurtherrefinethefinaldocument.TheJTAculminatedintheproductionofsevenkeytasks,fivetestableandtwonottestable,foreachspecialty.AlsoincludedinthefirsttwophasesoftheJTAwereCE“blueprint”categoriesspecies,organsystemandprocess/topictosupplementthekeytasksinmappingCEcontent.ThefinalproductislistedinAppendixX.BackgroundTheAmericanBoardofVeterinarySpecialties(ABVS)requiresthateachconstituentspecialtycollegeorboardconductaJobTaskAnalysis(JTA)atleastevery10years.TheABVSdefinesaJTAasfollows:Asystematicprocedurefordefiningthetasksrequiredbyajobandtheknowledge,skills,abilities,andotherpersonalcharacteristicsrequiredofindividualsperformingthatjob.Theresultsofajob/taskanalysisformthebasisfordeterminingtheexaminationcontentsnecessarytotestmasteryofthatfield.

TheACVPconductedaRoleDelineationStudy(RDS)in2007–8,facilitatedbyDr.JimHendersonofCastleWorldwide.Resultsofthisstudywerepublishedin2009andareincludedasAppendixB1.AtestplanwasdevelopedbasedonthatstudyandtheExaminationCommittee(EC)mappedtestitemstothetestplanbeginningin2010.SuccessiveECshaverevisedthetestplantomoreaccuratelyreflectexamcontent,whilestilladheringtotheresultsoftheRDS.

TheCertifyingExaminationBoard(CEB)wasformedin2011andreviewedthetestplanannually.In2012,thetestplanwasevaluatedindepthandmodifiedbyasubcommitteeoftheCEBwiththesupportofDr.Henderson.TheCollege’sdecisionin2015toredesignthePhaseIICertifyingExamination(CE),withimplementationin2017,promptedtheneedtoconducta

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newRDS.TheCEBelectedtouseterminology“JobTaskAnalysis(JTA)”ratherthanRDSgoingforwardastheformerisconsistentwiththeterminologyusedbytheABVS.

In2015,theCEB,startingwiththedataandconclusionsderivedfromthe2009RDS,developedandapprovedtheScopeoftheACVPCertifyingExaminationdocumentsforthePhaseIIexaminationforanatomicandclinicalpathology(AppendixB2).Thesedocumentsdefinedthekeytasksperformedbyentry-levelveterinarypathologistsengagedinbothspecialties.

InMarch2016,theCEBfinalizedaplanforconductingtheJTA,withanobjectiveofcompletingtheJTAandgeneratingaCEcontentBlueprintforthe2017PhaseIICEandthe2018PhaseIexaminationbythe2016AnnualMeeting.AlthoughaJob/TaskAnalysisisabestpracticeforhighstakescertifyingexaminations,thereisnosinglemethodrecommendedforconductingthisanalysis(NationalCommissionforCertifyingAgenciesStandardsfortheAccreditationofCertifyingPrograms,Standard10).TheCEB,withapprovalofACVPCouncil,electedtoconductaJTAbuildingonthedatacollectedfromthe2007-8RDS,theexperiencegainedbytheECandtheCEBoverthelast7yearsworkingwiththetestplanbasedonthatstudy,thecurrentCEtestplanmatrixandtheScopeofACVPCertifyingExaminationdocuments.TheCEBalsorecognizedthatthecompositionofthecurrentexamination,developedannuallyforoverfivedecadesbygenerationsofExaminationCommitteemembersrepresentativeoftheCollegeatlarge,representsvaluablehistoricaldatarelativetoCEcontent.

Process

Invention.ThisphasewasconductedbytheextendedCEBcomposedof11coremembersappointedbyCounciland9adhocmembersrepresentingACVPcommitteesandappointedpositionswithCE-relatedresponsibilities.TheobjectiveofthisphasewastoproducedraftJTAdocumentsforAnatomicandClinicalPathologyforsubsequentlevelsofbroaderreview.Thesedocumentsincludedassignedpercentagesfor:1)eachofthetestableTasksidentifiedintheoriginalScopeoftheACVPCertifyingExaminationasneededfor“AbilityatEntry”anatomicandclinicalpathologistsand2)“Blueprint”categoriesofspecies,organsystemandprocesstobeappliedacrossallTasksforeachspecialty.Membersparticipatinginthisphaseofexam,representingbothAnatomicandClinicalPathology,arelistedinAppendixI.1.TheInventionPhasefinaldraftJTATasksforClinicalPathologyarelistedbelow.DetaileddescriptionsoftheTasksandtheblueprintcategoriesgeneratedduringtheInventionPhase,includingexaminationcontentproportions,aredescribedinAppendixI.2.

• TASK1:Identify,describeandinterpretmicroscopicabnormalitiesinblood,bonemarrow,bodyfluids,andtissues(cytologyandhistology)fromdomesticandnon-domesticanimals

• TASK2:Recognizeandinterpretstaticvisualtestresultspertinenttoveterinaryclinicalpathology

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• TASK3:Interpretandcommunicateclinicopathologicdatafromdomesticandnon-domesticanimals

• TASK4:Knowtheprinciplesofcommonlyusedlaboratoryinstrumentationandmethods

• TASK5:Knowpathophysiologyanddiagnosisofdisease,withemphasisonmanifestationinlaboratorytestdata

• TASK6:DemonstrateknowledgeofthebasicmechanismsofdiseaseNON-TESTABLETASKS

• TASK7Composeandcommunicateinterpretationandsignificanceofresults• TASK8KnowandUnderstandQualityAssurance

Refinement.Inthisphase,apanelcomposedof14ClinicalPathologistsrepresentativeofthedemographicsoftheCollegereviewedthedraftJTAtasksandprovidedfeedbacktotheCEBforrefinementconsideration.Membersofthepanel,includingtheirdemographicinformation,arelistedinAppendixR.1.Demographiccategoriesincludedtimeasadiplomate,employmentsector,andPhDornoPhD.

Membersofthetwopanelswereprovidedbackgroundinformation(AppendixR.2)andgiventheopportunitytodiscussthedraftJTAthroughtwowebinarshostedbyCEBmembers.Panelmembersprovidedfeedbackviaanon-linequestionnaire(AppendixR.3).CompleteresultsofthesurveyareincludedinAppendixR.4.Asaresultoffeedbackfromthepanelists,anumberofchangesweremadetothetasksandblueprintcategories.Themostsignificantchangewastheadditionofa6thtaskcoveringthecontentofthePhaseI,GeneralPathologyExam:“Knowthebasicmechanismsofdisease”.MinorchangesincludedadditionofmissingorclarifyingitemdetailwithinsomeoftheTasks.Thismodifieddocument(AppendixR.5)wasthendistributedtothemembershipforreviewandfeedback(ValidationPhase).

Validation.Inthisphase,theACVPmembershipwasaskedtoparticipateinanon-linesurveyaskingfora1-3levelagreementforessentialityofeachtaskanda1–4levelagreementfortheproportionofeachtaskonthecertifyingexamination.Memberswerealsoaskedtoprovidereasonsfordisagreements.FeedbackfromthesurveywasusedtovalidatetheconclusionsofthefirsttwophasesoftheJTAandtofurtherrefinethefinaldocument.Allactiveandemeritusmembersweresurveyed,numbering354clinicalpathologists.115clinicalpathologistsrespondedtothesurvey,32%ifthosesurveyed.Therewasagoodbalanceofrespondentsbyemploymentsectorandyearsofexperience.

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Employmentsector Percentresponding

Academia 47.83Diagnosticlaboratory 37.39Government 0.87Industry 11.30Other(zoo,conservation,consulting,etc.) 2.61

Yearpassedthecertifyingexamination Percentresponding

2010-2015 42.611995-2009 37.391994orearlier 20.00

Backgroundinformationwasprovidedtothemembership,whichincludedadescriptionoftheJTApublishedintheACVPNewsletter(AppendixV-1)andanemaildistributedtothemembershipwiththesurveywhichincludedalinkto theJTAdraftdocument(AppendixV-2).ThesurveyquestionnaireisatAppendixV-3andthesurveyresultsareatAppendixV-4.Responsestothemembershipsurveyaresummarized:

Q1:Ratetheextenttowhichanentry-levelveterinaryclinicalpathologistshouldbeabletoperformatask.TherewasmarkedmajorityratingofEssentialtoModeratelyEssentialforalltestableTasks,witharankorderingfrommostessentialbeing:Tasks1,3,5,6,2and4.Anyresponses“notessential”representedamarkedminority.Fornon-testableTaskstherewasstrongagreementforTask7beingessential.TherewasamixofagreementforTask8,proficiencyinlaboratoryandqualitymanagement,beingessential.

Q2:DoyouagreewiththeproposedproportionoftasksonthephaseIIexamination?Therewereanumberofcommentsrelatedtothedistributionoftasksintheexamination.Thesetendedtocanceleachotherout.ExamplesincludesomerecommendedincreasingTask1,whileothersrecommendedadecrease.Theseresponseswerefromasmallminority.Giventhatthemajoritysupportedtheproposeddistribution,nochangeswillbeimplementedintheproposedtaskdistributionsforthePhaseIIexam.

Q3:Aretherecriticaltasksforentry-levelclinicalpathologistsomittedinthisJTA?80%oftherespondentsindicatednoomittedcriticaltasks.20%indicatedcriticaltaskswereomittedandprovidedawiderangeofrecommendationsformodifying/addingtodrafttasks.Therewereseveralcommentsregardingimportanceofqualityassurance,laboratorymanagement,qualitymanagement,“abilitytoassessresearchliteratureandapplynewknowledge”,criticalevaluationofliterature,andcommunicationskillsacrosstheclinicalpathologistinterfaceaudience.Someofthesearenon-testabletasksand/orofquestionablerelationshiptoentry-

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levelskills/knowledge.TheCEB/CEshouldconsiderclarifyingwhatelementsofQAaretestableandincludedunderTask4,instrumentationprinciples.Forexample,principlesofqualityassuranceandmethodvalidationareintendedtobeincludedinTask4.

Q4:Fractionofjobrolesinwhichmicroscopyconsistsofhistologicinterpretations.

Ahighmajorityindicatedlittletonoinvolvementinhistology,with0%(48%ofrespondents)and1-10%(42%ofrespondents).Eightindividualsrespondedinthe11-25%ofmicroscopycategory.Asmallnumberindicatedgreaterthan26%toamajorityoftheirmicroscopyconsistedofhistologicinterpretation.Thefewthatpracticeamajorityofmicroscopyinvolvinghistologyhavelikelyevolvedajobrolethatbridgesbothclinicalandanatomicalpathologymicroscopyskills.Afewspontaneouscommentsweremixedontheimportanceofhistologyforentry-levelclinicalpathologists.

Q5:UtilizationofDigitalMicroscopy

Themajority(69%)indicated0%useofdigitalmicroscopy.Thisisappropriateforthecurrentstateoftechnologyinmostclinicalpathologymicroscopysettings.About30%ofrespondentsindicatedutilizationbetween1and25%ofmicroscopicinterpretations,withmostofthesebeinginthe1-10%category.Twoindividualsindicated>50%oftheirmicroscopyisdigital.Itispossiblethatthoseusingdigitalmicroscopyhaveevolvedjobrolesthatinvolvevariousfractionsofhistopathology,assuggestedbyresponsestoQ4.

Q6:Concerns/SuggestionsfortheCEBrelatedtotheJTA.

Abouthalfofthecommentsindicated“None”orprovidedpositivefeedbackregardingtheexamevolutionprocess.

Therewasascatteringofafewindividualcomments.Examplesincludeameasuretotestqualitymanagementandrepresentationoftoxicologicpathology.

AcoupleofcommentsexpressedlackofunderstandingoftheJTAprocess.

Acoupleofcommentssuggestedthatesoterictestitemsshouldbeavoided–bothfromliteratureandinpracticalrecognitionskills.Aspartoftheexaminationre-designeffort,boththeCEBandEChaveagreedtoasetoftestitemdevelopmentguidelinesthataddressthisconcern.Theseguidelinesareoutlinedinthedocumenttitled“PrinciplesofACVPExaminationContentDevelopment(AnatomicandClinicalPathology)”.ThisdocumentispostedontheACVPwebsite.

MembershipSurvey(Validation):ConclusionsTherewasgoodagreementwiththeessentialityofalltasks.TherewasalsogoodagreementonthedistributionoftasksproposedtobeexaminedinthePhaseIIexamination.Commentsondistributionoftasksintheproposedexaminationstructuretypicallycancelledeachotherout;inotherwords,foraminorityrecommendedshiftindistributioninonedirection,therewastypicallyacorrespondingminorityshiftindistributionintheoppositedirection.Theseminority

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responsesappearedrelatedtoeitheruniqueemploymentexperiencesand/oruniqueperspectives,oronafailuretoreviewtheprovidedbackgroundinformation.Basedontheresponses,themembershipsurveyvalidatedtheinventionandrefinementJTAproposalforTasksanddistributionofTasksinthePhaseIIexamination.Althoughthesurveyclearlyconfirmedthatahighmajorityofveterinaryclinicalpathologistshavelittletonoinvolvementwithhistopathology,itwastheconsensusoftheCEBthatexposuretohistopathologicchangesincommonlysampledtissues/lesionsenhancesone’sunderstandingoflesionbiologyandcytologicsamplemanifestations.Theabilityofanentry-levelclinicalpathologisttoperformhistopathologicevaluations,asaddressedinthissurveyquestion,isadifferentquestion.TheCEBwillneedtofurtheraddresstheroleofhistologyskillintheClinicalPathologycertifyingexamination.

Likewise,theroleofdigitalslidescanningintheclinicalpathologistJTArequiresmonitoringovertime.Digitalslidescanningatthispointintimeismoreadaptabletohistopathology.Forcytopathologysamples,digitalslidescanningiscurrentlytypicallynotappropriateinmostdiagnosticsettingsgiventhelimitationsofcurrentslidescanningprotocols.FinalProduct.ThefinalcriticaltasksandblueprintcategoriesforClinicalPathology,listedbelowandinAppendixX,wereapprovedbymajorityvoteoftheCEBandsubmittedtoACVPCouncilon[date]forfinalapproval.

TASK1:Identify,describeandinterpretmicroscopicabnormalitiesinblood,bonemarrow,bodyfluids,andtissues(cytologyandhistology)fromdomesticandnon-domesticanimals

• Testedviaglassslidesandimage-basedmultiplechoicequestions(MCQs)• ~30%ofPhaseII

Skillsandknowledgeto:• Writeacoherent,organizeddescriptivereport• Writeaconcisesummaryrelativetothedescriptivefindings• Writeaninterpretiveconclusion(s)and/ordiagnosis(es)• Listappropriatedisease(s),condition(s),and/ordifferentialdiagnoses• Listpotentialcauses(s)• Describeassociatedchangesinotherorgan(s)• Outlineappropriateancillarytestsandanticipatedresults(e.g.specialstains,

immunohistochemistry,electronmicroscopy,PCR-basedclonality,flowcytometry,cytology,otherspecializedlaboratorytestsinrealmsofbiochemistry,serology,microbiology,immunodiagnostics)

TASK2:Recognizeandinterpretstaticvisualtestresultspertinenttoveterinaryclinicalpathology

• Testedviaimage-basedMCQs• ~10%ofPhaseII

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Skillsandknowledgeforinterpretationof:• Hematologycytograms• Flowcytometryplots• Coagulationtracings• Plateletaggregationplots• Macroscopichematologytestresults(eg.Coombstests)• Grossappearanceofsubmittedsamples• Specialandimmunochemicalstains• Electronmicrographs• Qualityassuranceandqualitycontroldata• Proteinelectrophoretogramsandimmunofixationreactions• PCRclonalityresults

TASK3:Interpretandcommunicateclinicopathologicdatafromdomesticandnon-domesticanimals

• TestedviacaseessaysandMCQs• ~30%ofPhaseII

Skillsandknowledgeto:• Describepathophysiologyofconditionsleadingtolaboratoryabnormalities• Integratelaboratoryabnormalitiesintoadiagnosis(ordifferentialdiagnoses)• Recommendappropriateancillaryteststofurtherconfirmdefinitiveordifferential

diagnoses• Interpretpopulationlaboratorydataorstudysetdata• Interpretintegratedlaboratoryresults(biochemistry,urinalysis,serology,

microbiology,serumproteinelectrophoresis,immunodiagnostics,coagulation,hematology,etc.)

TASK4:Applytheprinciplesofcommonlyusedlaboratoryinstrumentationandmethods

• Testedvianon-imagebasedMCQs• ~10%ofPhaseII

Usingknowledgeto: • Describeanalyzerandtestproceduremethodologies• Listsampletypesandcollectionmethods• Describeproceduresforreferenceintervaldetermination• Listerrorsandinterferences(pre-analytical,analyticandpost-analytical)• Definetestproperties(sensitivity,specificity,predictivevalues,ROC,etc.)and

selection• Describequalitycontrol,qualityassurance,relevantstatistics• Describeproceduresforreferenceintervalandmethodvalidationprinciples• Describeroutine,specialandimmunochemicalstains • Describeprinciplesoflightmicroscopy• Listtherulesandregulationsforlaboratorysafetyandbiosafety

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TASK5:Applyknowledgeofthepathophysiologyanddiagnosisofdisease,withemphasisonmanifestationinlaboratorytestdata


Usingknowledgeofpathogenesis,etiologyandorgan-basedcausestoanswer questionsconcerningthefollowingdiseaseprocesses:

• Geneticalteration • Disturbanceofgrowth/neoplasia • Cellaging/degeneration/injury/death • Infection/immunity/inflammation • Metabolic/nutritional/deficiency • Hemodynamic/vasculardisease

TASK6Demonstrateknowledgeofthebasicmechanismsofdisease

• Testedvianon-imagebasedMCQs• 100%ofPhaseI(SeePhaseITopicDistributionbelow)

Usingknowledgeof:• Mechanismsfundamentaltodiseaseinanimals,includingprinciplesof:

o Cellularinjuryo Inflammationandrepairo Hemodynamicdisorderso Physicalandchemicalinjuryo Neoplasiao Congenitalandgeneticdiseaseso Molecularpathologyo Infectiousprocesseso Immunology

• MechanismsaregeneralinnatureinthattheyrelatetomostanimalspeciesNON-TESTABLETASKS

TASK7Composeandcommunicateinterpretationandsignificanceofresults

• Writeclinicalpathologyreportsusingtraining,experience,professionaljudgmentandotherinformationinordertoconveytheinterpretationinaclear,concise,andaccuratemanner.

• Communicatethesignificanceofclinicalpathologyresultsusingclear,conciseoralandwrittenlanguageinordertoconveythepotentialimplicationsforasubject,patient,orpopulation(animaland/orhuman).

TASK8Demonstrateproficiencyinlaboratorymanagementandqualitypractices

• Definestandardoperatingproceduresinaccordancewithprescribedmethodsinordertoensureacceptablelevelsofqualityandconsistency.

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• Evaluatespecimens,reagents,instruments,andpersonneltrainingbyinspection,reviewanddocumentationinordertoensurethevalidityofdata.

• Evaluatedataforevidenceofpre-analyticalandanalyticalerrorthroughinspectioninordertodetermineifverificationandtroubleshootingarerequiredtoobtainreliableresults.

• DemonstrateoveralllaboratorymanagementaptitudePhaseIIBlueprintCategoryTargetsDistributionbySpecies(PhaseII)S1Domestic 70–85% S2Labanimal 10–15% S3Non-domestic 5–10% DistributionbyOrgansystem(PhaseII) O1 Hemolymphatic,includingcoagulation 20–25%O2 Skin/Integument 6–12%O3 Cardiovascular 2–4%O4 Gastrointestinal 2–6%O5 Pancreas,exocrine 2–6%O6 Liver 12–15%O7 Endocrine 8–12%O8 Renal,includingurinalysisandurinarytract 15–20%O9 Respiratory 2–6%O10 Nervousandspecialsenses 2–4%O11 Musculoskeletal 2–6%O12O13O14

ReproductiveMultiorgan/Systemic/OtherNon-organbased*

2–4%2–6%10–20%

*Definedasmostlyprinciplesoflaboratorytechnology,fromselecteditemsinTasks2and4.

Distributionbytopic(PhaseII) C1Genetic 5–10%C2Disturbanceofgrowth/neoplasia 20–30%C3Cellaging/degeneration/injury/death ~5% C4Infection/immunity/inflammation 25–35% C5Metabolic/includingendocrinopathy,acidbase,10–15%abnormalbiochemistry C6Hemodynamic/vasculardisease ~5% C7Laboratorytechnology/analysis 15–20%

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PhaseI(GeneralPathologyBlueprint)

Distributionbytopic(PhaseIExaminationtargets,sameforbothAnatomicalandClinicalPathology)C1Genetic 5–10%C2Disturbanceofgrowth/neoplasia 15–25%C3Cellaging/degeneration/injury/death 5–15%C4Infection/immunity/inflammation 35–55%C5Metabolic/nutritional/deficiency 5–10%C6Hemodynamic/vasculardisease 5–10%C7Laboratorytechnology/analysis 3–5%

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AppendixTableofContents

AppendixTitle Page(s)

B12009RoleDelineationStudy 12-151

B2ScopeoftheACVPCertifyingExamination–ClinicalPathology 152

I1InventionPhasePanelParticipants 153

I2InventionPhaseDraftJTATasks 154-161

R1RefinementPhasePanelParticipants 162

R2RefinementPhaseBackgroundInformationEmail 163-164

R3RefinementPhaseQuestionnaire 165-168

R4RefinementPhaseSurveyResults 169-185

R5ModifiedTaskandBlueprintDocument 186–189

V1ACVPNewsletterJTADescription 190-191

V2EmailtoACVPMembershipDescribingSurvey 192-195

V3ValidationPhaseQuestionnaire 196-199

V4ValidationPhaseSurveyResults 200-210

XTaskandBlueprintLists 211-214

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American College of Veterinary Pathologists Role Delineation Study for the

Veterinary Anatomic Pathologist and the Veterinary Clinical Pathologist

REPORT

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B1 2009 Role Delineation Study

American College of Veterinary Pathologists 2 Role Delineation Study

Table of Contents Executive Summary ...............................................................................................................................4

Introduction ............................................................................................................................................5

Initial Development and Evaluation .....................................................................................................7

Validation Study ..................................................................................................................................10

Questionnaire Design, Sampling Plan, and Distribution .....................................................10

Who Responded to the Survey? ............................................................................................10

Validation of Veterinary Anatomic Pathologists’ Role .......................................................21

Anatomic Elements of Practice................................................................................21

Tasks Within Anatomic Elements of Practice ........................................................26

Anatomic Foundational Sciences ............................................................................43

Specific Sciences Within Anatomic Foundational Sciences..................................46

Anatomic Tools.........................................................................................................48

Validation of Veterinary Clinical Pathologists’ Role ..........................................................54

Clinical Elements of Practice...................................................................................54

Tasks Within Clinical Elements of Practice ...........................................................58

Clinical Foundational Sciences................................................................................73

Specific Sciences Within Clinical Foundational Sciences.....................................76

Clinical Tools............................................................................................................77

Reliability Analysis for Elements of practice Scand Foundational Sciences...................................84

Conclusion............................................................................................................................................86

Appendix A: Analysis of Data for New Diplomates (2003 – 2007)

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Executive Summary Background In 2006 the Council of the American College of Veterinary Pathologists (ACVP) decided to perform a study to define the roles of practicing veterinary anatomic pathologists and veterinary clinical pathologists. This activity was intended to provide objective data to be used (1) to ensure that certification examinations are fair, relevant and legally defensible; (2) to improve the curricula of training programs in veterinary pathology; and (3) to guide the creation of continuing education programs for established veterinary pathologists. A Role Delineation Task Force of nine ACVP diplomates comprised of six anatomic pathologists and three clinical pathologists was selected by the ACVP Council to design and oversee the study. In response to requests from the ACVP, five consulting firms with recognized credentials in professional testing services provided proposals. In 2007 the ACVP engaged CASTLE Worldwide to help define the current roles, tasks, and requisite knowledge of practicing veterinary anatomic pathologists and veterinary clinical pathologists. Methods To define the questions to be used in the role delineation surveys, separate, face-to-face focus groups of ACVP diplomates from each veterinary pathology specialty with representation from diverse areas of practice were held in November, 2007. CASTLE staff led by Dr. James Henderson, the supervising consultant, facilitated these focus groups. Working separately and in combination, the anatomic pathology and clinical pathology focus groups defined the relevant Elements of Practice (broad activities of the profession), Tasks (more specific activities within each Element of Practice), Foundational Sciences (broad disciplines of importance to proficient professional practice), Specific Sciences (more specific areas of knowledge within a Foundational Science), and Tools (methods and instruments employed in undertaking their regular Tasks) used by veterinary pathologists in the current professional practice of each specialty. These groups also provided recommendations on demographic questions to be used to better understand and utilize survey responses. The information from the focus group sessions was used by Dr. Henderson and the Role Delineation Task Force to create the ACVP role delineation surveys for each specialty. All active ACVP diplomates were requested to complete the survey for their specialty during February and March of 2008. Diplomates certified in both veterinary anatomic pathology and veterinary clinical pathology were asked to complete both surveys. Diplomates were instructed to answer each question in the context of the respondent’s current role and practice. For this survey, current roles, tasks, and skills are those used in today’s practice regardless of their age, novelty or complexity. Objective information regarding the current roles and required knowledge of individual practicing pathologists offers the best guidance for design of relevant educational programs and selection of appropriate examination content. Diplomates were specifically instructed not to offer their opinions on what tasks, knowledge, and tools might be important to the practice of veterinary pathology in the future. Emeritus (retired) ACVP diplomates were excluded from the survey because responses based on their past roles or opinions might not accurately reflect actual current practice of the veterinary pathology specialties. The rating scales for each category of question used in the surveys (Elements of Practice, Tasks, Foundational Sciences, Specific Sciences, and Tools) are described in this report. Mean scores and standard deviations were calculated for each survey item. Mean ratings from all diplomates and from a subset consisting of all responding diplomates certified in 2003-2007 were calculated separately. Data provided by diplomates recently certified (since 2003) were analyzed based on the premise that information acquired from recently qualified practitioners may more accurately reflect the demographics

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and real-world roles of entry-level veterinary pathologists than would responses obtained from all diplomates. In general, responses from all diplomates and recent diplomates were similar. A post hoc comparison of results obtained from diplomates employed by academic institutions and by industrial firms was undertaken to determine the similarities and differences in roles of veterinary pathologists in these two broad practice settings. This latter evaluation was performed to examine potential differences in training and certification needs of pathologists practicing in these two environments. Survey Results Usable responses were received from 713 of 1237 anatomic pathology diplomates and 133 of 266 clinical pathology diplomates, resulting in response rates equaling or exceeding 50%. The testing consultant expressed confidence that this high response rate would produce reliable data. The results obtained from the role delineation surveys for each veterinary pathology specialty are available in this report. Detailed survey results from all diplomates and from recent (2003-2007) diplomates of each specialty are listed separately. In addition, comparisons of results from diplomates of each specialty employed by academic institutions and industry are available in separate documents (http://www.acvp.org/roledelin/index.php). A primary use of the role delineation data is the creation of written Test Plans, i.e. examination specifications that guide the selection and distribution of examination content for each specialty. Such Test Plans define the tasks that should be evaluated during the certifying examinations and guide the relative weight or emphasis of examination content to be assigned to each task. Written Test Plans are a critical means of assuring that certifying examinations are objective measures of proficiency in important job-related tasks, and therefore legally defensible. Anatomic Pathology and Clinical Pathology Test Plan Working Groups were appointed by the ACVP Council in the fall of 2008 to create separate Test Plans for each specialty. Most members had ACVP Examination Committee experience. Two members of each working group also had served on the ACVP Role Delineation Task Force to provide continuity. The three charges given to these working groups were to:

1. Set threshold criteria based on role delineation survey results to define tasks and knowledge that should be evaluated within the certifying examinations for veterinary clinical pathology and veterinary anatomic pathology. The criteria were established to emphasize specific tasks because legal precedent and scientific literature indicate that the most suitable data to use in defining appropriate content for professional certifying examinations are current tasks.

2. Identify tasks and knowledge that should not be evaluated within the formal certifying examinations for veterinary clinical pathology and veterinary anatomic pathology. Tasks may be excluded based on role delineation survey data or because some important tasks cannot be adequately evaluated in a traditional examination setting.

3. For the tasks that should be assessed in the certifying examinations, develop a systematic process to determine the relative weight (emphasis) of each task within the examination content. The Test Plans for Veterinary Clinical Pathology and Veterinary Anatomic Pathology are available at (http://www.acvp.org/roledelin/index.php).

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Introduction The American College of Veterinary Pathologists (ACVP) conducted a worldwide analysis of the responsibilities and duties of diplomates in veterinary pathology beginning in November 2007 and continuing through March 2008 for the purpose of defining logical, practice-related, and research-based content for its certification examinations. Key to the effort, ACVP appointed a role delineation task force that provided leadership and oversight for the project. The task force identified groups of diplomates in both specialties, veterinary anatomic pathology and veterinary clinical pathology, who met with CASTLE Worldwide, Inc., to define the major elements of practice and tasks of diplomates in both specialties, as well as the foundational sciences and specific sciences required to perform the tasks in a competent way. The panels comprised diplomates from throughout North America. The panel met for three days in Savannah, GA in conjunction with the 2007 annual meeting of the ACVP. The groups were charged with analyzing the role of the diplomate at all levels of experience, with particular attention to the divergent ways that veterinary pathology may be practiced in different settings and industry classifications. Consistent with the purpose of the study, ACVP desired to adhere to established standards within the professional testing community for the conduct of role delineation studies. These guidelines have their foundation in logically sound and legally defensible procedures drawn from psychometric literature and case law. These principles and procedures are outlined in federal regulation (Uniform Guidelines on Employee Selection Procedures) and manuals, such as Standards for Educational and Psychological Testing (published by the American Educational Research Association, 1999). CASTLE employed these standards as well as those of the National Commission for Certifying Agencies (NCCA, 2006) in all phases of the study. As the primary process for identifying the competency areas and knowledge needed for proficient performance in a profession, a role delineation study supplies a clear and useful basis for defining the essential content of professional certification examinations. This is because role delineation studies provide the basis for content validity, which is the most commonly applied and accepted validation strategy for establishing certification and other types of standard-setting programs. Validation through a systematic role delineation study helps to document that the competence to be inferred when a candidate has passed the board certification examination bears a sound linkage to the significant elements of practice and foundational sciences that define the profession. This was the underlying intent of the study. ACVP’s role delineation study is an integral part of ensuring that the certification examinations in each specialty have practice-related validity and that the aspects of veterinary pathology addressed by the certification and training programs reflect the requirements in the variety of practice settings. The study identified the point of acquisition, criticality, and frequency of elements of practice, tasks, and foundational sciences, as well as the criticality of specific sciences. These ratings will play an important role in determining the content of the examination. The role delineation study for the diplomate in veterinary pathology consisted of the following three major phases, which provide the organization of this report:

I Initial Development and Validation. The role delineation panels identified the elements of practice, tasks, foundational sciences, and specific sciences essential to the proficient practice of veterinary pathology by ACVP diplomates.

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II. Validation Study. The entire body of diplomates in the two specialties of veterinary pathology were invited to review and validate the work of the role delineation panels. A qualified and representative sample of diplomates actually participated in this phase.

III. Development of Specifications for Training and Testing. Based on the ratings gathered

from the representative sample of professionals, a plan for the examinations for veterinary anatomic pathologists and for veterinary clinical pathologists was developed, including specifications to provide direction for assembling the certification examination as well as enhancing the training and continuing education programs of the College.

ACVP appointed a task force to provide leadership for the role delineation study. This group met by conference call regularly, advised CASTLE about key activities, and reviewed the report many times. The task force was essential to the project’s success. Members of the task force are listed below: Daniel Morton, DVM, PhD, DACVP (Task Force Chair) Pfizer, Inc. Linda M. Berent, DVM, PhD, DACVP University of Missouri Brad Bolon, DVM, PhD, DACVP GEMpath, Inc. Kelli L. Boyd, DVM, PhD, DACVP St. Jude Children’s Research Hospital Gary D. Coleman, DVM, MEd, MSS, PhD, DACVP U.S. Army Medical Research and Material Command Robert L. Hall, DVM, PhD, DACVP Covance Laboratories Michael J. Kinsel, DVM, DACVP University of Illinois College of Veterinary Medicine Susan J. Tornquist, DVM, PhD, DACVP Oregon State University Dennis W. Wilson, DVM, PhD, DACVP University of California-Davis

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INITIAL DEVELOPMENT AND EVALUATION

ACVP is investigating the roles and responsibilities of diplomates in veterinary pathology for the purpose of validating its certification examinations as well as providing direction for enhancing its training and continuing education programs. As part of the inquiry, ACVP conducted a role delineation study in late 2007 and early 2008. Facilitated by CASTLE, two representative panels of diplomates (one for anatomic pathology, the other for clinical pathology) met in Savannah, GA, in conjunction with the annual ACVP meeting to discuss the role of diplomates in each specialty. The result of the meeting was an outline of elements of practice, tasks, foundational sciences, and specific sciences that work to define the unique role of diplomates in the specialties. The panels included a sample of practicing diplomates living and working throughout the United States. Two key definitions provide clarity for the inquiry: Target Audience: The target audience for the role delineation study included all ACVP diplomates in veterinary anatomic pathology and all ACVP diplomates in veterinary clinical pathology, including individuals with certification in both specialties. Veterinary pathologists are scientists who are qualified to investigate pathologic changes in animals. They are doctors of veterinary medicine (or equivalent) and have completed at least three years of post-veterinary school training in veterinary pathology. They work in academia, diagnostic labs, industry, state or federal government agencies, or private consulting practices carrying out a diverse range of activities. Veterinary anatomic pathologists guide and conduct research and investigations, and make and communicate diagnoses or interpretations based on laboratory tests, examination of tissue and body fluid specimens, and clinical information. Veterinary clinical pathologists conduct studies of cells, body fluids, and other samples for the purpose of diagnosing and understanding disease processes. Stakeholders: The term stakeholders refers to the different groups that have an interest in the proficient practice of veterinary pathology. Major stakeholder groups might include members of the College, candidates for the certifying examinations in either specialty, employers, animals and their owners, and the public.

• Members of the veterinary pathology specialties are stakeholders to the degree that the quality of the training and certification programs and their rigor are appropriate preparation for proficient practice.

• Candidates for the certifying examinations expect the certification process to be directly related to practice and appropriate preparation for proficient practice. They expect that all candidates for certification will be held to a uniform, well-reasoned standard.

• Employers and their staff benefit when the knowledge and skill required for successful certification are rigorous enough to ensure that veterinary pathology diplomates can readily assume and perform their duties in a proficient manner.

• Animals are stakeholders in veterinary pathology (even though they cannot express a point of view) because they or their surviving herd mates are often the direct beneficiaries of veterinary pathology services. Their interests concern the content of veterinary pathology in topics related to their conditions and the specified depth and breadth of knowledge to conduct accurate pathology studies. Animals would expect that the knowledge and skill specified through the role delineation study are sufficiently advanced to meet their individual and collective needs.

• Although the public is a key stakeholder in veterinary pathology, the interests of this group are sometimes difficult to quantify. At the broadest level, the public benefits when the knowledge and skill required for certification are advanced enough to meet the needs of society and oriented

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toward topics that are critical to proficient practice and preserving public health. At a more specific level, the public benefits when the direct recipients of veterinary pathology services receive proficient service at a reasonable cost.

Early Steps in the Study The first steps in conducting the study included a preliminary analysis of veterinary pathology, the preparation of instructional materials, and the three-day meeting with panels of diplomates (one for the anatomic pathology specialty, the other for the clinical pathology specialty) representing a broad range of practice settings. The purpose of the preliminary analysis was to inform CASTLE of the essential responsibilities of the diplomate and key terminology in both specialties. Building on this information, CASTLE prepared instructional materials that panelists used to learn about the role delineation study and that CASTLE used to convey essential explanations during the meeting. The objective of the panel meetings was to define the elements of practice and tasks, as well as the foundational sciences and specific sciences, required for proficiency at all experience levels for both specialties.

Preliminary Analysis CASTLE desired to gain an acquaintance with the roles and major responsibilities of diplomates in the specialties in order to provide leadership for the role delineation study. In support of this desire, ACVP provided CASTLE with documents that guide its training programs in veterinary pathology. The ACVP website also offered helpful insight. As valuable as CASTLE’s reading was, however, interviews with all members of the role delineation task force and input from that group into the instructional materials that CASTLE developed helped to build understanding at a far more helpful level.

Instructional Materials Key to the success of a role delineation meeting with panelists are the materials used to inform participants about key concepts. The instruction booklet for the role delineation study included ACVP’s definition of the diplomate and essential definitions and examples for elements of practices, tasks, foundational sciences, and specific sciences. The instruction booklet also included a set of validation scales that are commonly used in role delineation studies and worksheets that were used for various purposes in the project. Instructional materials were used during the panel meetings as a means of building understanding among panelists about key concepts and terms and to orient panelists to the essential thought processes and activities of the meeting.

Role Delineation Meeting CASTLE consulted with ACVP’s role delineation task force on the development of guidelines by which to select participants for the role delineation meeting, advising to account for the diversity in practice settings and industry classifications, as well as the major geographic regions of North America. Following this advice, ACVP culled its databases and worked with volunteer leadership to identify panel participants from generally representative groups. ACVP recruited two diverse and well qualified panels, one for each specialty. The two panels met together for the first portion of the meeting. After reviewing and reaching consensus on the target audience definitions, panelists offered suggestions for elements of practice, in the belief that these descriptors apply similarly to both specialties. Through facilitated discussion, the panels reached

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consensus on very similar lists. However, panelists determined that lists of foundational sciences would be more appropriately negotiated with discussion limited to the individual specialty panels.

Veterinary Anatomic Pathology

Veterinary Clinical Pathology

Elements of Practice: Research and Investigative Design Data Collection Data Analysis and Interpretation Communication and Reporting Quality Assurance Public Health and Risk Management Within

Human and Animal Populations Education and Professional Development

Elements of Practice: Research and Investigative Design Data Collection, Analysis, and Interpretation Communication and Reporting Quality Assurance Public Health and Risk Management Within

Human and Animal Populations Education and Professional Development

Foundational Sciences: Anatomy and Physiology Biology Physical Sciences Applied Mathematics and Statistics Medicine Pathology Microbiology and Infectious Disease

Foundational Sciences: Anatomy Applied Mathematics and Statistics Biology/Pathology Chemistry Microbiology Physiology/Pathophysiology Physics

For each element of practice the specialty panels worked in separate focus groups to draft tasks, which the whole specialty panel then reviewed and refined through a consensus process. Similarly, the specialty panels listed specific sciences to give definition to the foundational sciences. The panels’ diversity led to discussions which challenged the terminology, phrasing, and every aspect of the statements, with the resulting consensus representing a position that all members of the given specialty panel believed to be valid. At the end of the meeting in Savannah, specialty panel members evaluated each element of practice, task, foundational science, and specific science, rating each on importance and criticality to their current practice as a diplomate and the frequency with which they perform activities associated with each element of practice and task or employ each foundational science and specific science. It became evident in the process of rating that some scales were more meaningful than others. The responsibility of resolving which scales would be deemed most useful was given to the role delineation task force. Based on the work of the role delineation panels, CASTLE and ACVP developed an electronic survey for both specialties and distributed it to all qualified diplomates throughout the world. The results of the survey are the focus of Phase II.

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VALIDATION STUDY

I. Questionnaire Design and Distribution CASTLE developed an online questionnaire to be submitted to all ACVP board-certified veterinary pathologists using the element of practices, tasks, foundational sciences, and specific sciences identified by the specialty panels. The questionnaire phase of the role delineation study was important for this reason: people who work as veterinary pathologists should have input into the definition of their role. This input is critical because the panels, though highly qualified and representative in many key ways, constituted only a small portion of the specialists. Review from the greater communities within the specialties is essential in order to make generalizations about the elements of practice, tasks, foundational sciences, and specific sciences to the population of veterinary pathologists in each specialty. CASTLE collected validation data from participants using the questionnaire to evaluate, validate, and provide feedback about the description of each specialty. The questionnaire also solicited demographic information from the respondents to ensure that a representative response from practicing veterinary pathology professionals was achieved. The sampling plan was straightforward. ACVP surveyed all 1,468 diplomates (1,202 anatomic, 231 clinical, and 35 who are dually certified) by supplying contact information for these individuals in a spreadsheet to CASTLE. CASTLE mailed a letter on ACVP stationery, signed by the ACVP president and the chair of the role delineation task force, inviting all of these individuals to participate in the study. The letter included the URL at which the on-line survey was located, as well as individual usernames and passwords. CASTLE also e-mailed these individuals two days after the letter was mailed, explaining the purpose of the survey and its role in the study and asking for them to complete the survey. Of the questionnaires distributed for the survey, CASTLE received 846 qualified, usable responses. The final database of qualified, complete responses included 714 response records from veterinary anatomic pathologists and 133 from veterinary clinical pathologists. The overall response rate (57.6%) is considered excellent for a role delineation survey, especially given that the survey was long — 60 to 90 minutes were required to complete it — and complex. Accounting for the dually certified, the response rate for the anatomic pathology group was 57.7%, and 49.6% for the clinical pathology group. However, not all individuals responded to every question, so the total number of responses per question varies.

Who Responded to the Survey? One purpose of collecting demographic data was to determine the degree of diversity within the respondent group along dimensions that may be seen as influencing practice as well as the degree to which the respondent group reflects the known characteristics of the population of ACVP board-certified veterinary pathologists. A single demographic survey was used for both specialties; however, data are reported separately for the two groups. As shown in the demographic data and graphs on the following pages, the survey respondents represent the desired diverse population of professional practice settings. The first demographic question asked respondents to describe their educational achievements by indicating the post-baccalaureate degrees they have earned. As can be seen in Table 1 and Figures 1 and 2, virtually all respondents have earned a degree in veterinary medicine. In addition to the degree in veterinary medicine, more than half of the anatomic pathology respondents and just under half of the clinical pathology respondents have earned a Ph.D. A large portion of the group also has a master’s degree of one type or another.

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Table 1: Degrees Earned * Anatomic Clinical

Degree Frequency Percent Frequency Percent

DVM/VMD (or equivalent) 707 99.0 133 100.0 PhD 413 57.8 65 48.9 MBA 5 0.7 0 0 MPH 7 1.0 0 0 Other Master’s 181 25.4 48 36.1 Other General 72 10.1 23 17.3

* NOTE: Respondents could select more than one degree, so it is not reasonable to add the frequency or percent information. Figure 1: Degrees Earned — Veterinary Anatomic Pathologists

181

72

5 7

413

707

0

200

400

600

800

DVM/VMD PhD MBA MPH Other

Master's

Other

General

FREQUENCY

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Figure 2: Degrees Earned — Veterinary Clinical Pathologists

48

23

0 0

65

133

0

50

100

150

DVM/VMD PhD MBA MPH Other

Master's

Other

General

FREQUENCY

The second demographic survey question asked respondents to indicate the year in which they earned ACVP certification. Frequency distributions containing this information are reported as Table 2.

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Table 2: Year ACVP Certification Earned Anatomic Clinical Year

Frequency Percent Frequency Percent 1963 1 0.1 1966 1 0.1 1967 1 0.1 1968 2 0.3 1969 1 0.1 1970 5 0.7 1971 1 0.1 1972 6 0.8 1 0.8 1973 5 0.7 1 0.8 1974 9 1.3 1975 8 1.1 1976 7 1.0 1 0.8 1977 11 1.5 3 2.3 1978 13 1.8 1979 8 1.1 1980 19 2.7 1 0.8 1981 15 2.1 2 1.5 1982 21 2.9 3 2.3 1983 35 4.9 2 1.5 1984 17 2.4 3 2.3 1985 17 2.4 4 3.0 1986 14 2.0 3 2.3 1987 23 3.2 2 1.5 1988 20 2.8 1989 19 2.7 2 1.5 1990 23 3.2 3 2.3 1991 20 2.8 6 4.5 1992 18 2.5 3 2.3 1993 28 3.9 5 3.8 1994 16 2.2 8 6.0 1995 9 1.3 9 6.8 1996 22 3.1 2 1.5 1997 10 1.4 3 2.3 1998 22 3.1 3 2.3 1999 21 2.9 6 4.5 2000 25 3.5 6 4.5 2001 22 3.1 6 4.5 2002 20 2.8 2 1.5 2003 26 3.6 4 3.0 2004 42 5.9 14 10.5 2005 19 2.7 6 4.5 2006 36 5.0 8 6.0 2007 44 6.2 11 8.3

No Response 12 1.7 2 1.5 Total 714 100.0 133 100.0

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Table 3 summarizes data about certifications that respondents possess in other veterinary specialties. Given the high level of educational attainment that characterizes veterinary pathology, it is reasonable that a large number report holding current professional certifications in sister specialties. Table 3: Other Certifications Earned*

Anatomic Clinical Certification

Frequency Percent Frequency Percent ABVP 3 0.4 0 0.0 ABVT 2 0.3 0 0.0 ACLAM 18 2.5 0 0.0 ACPV 8 1.1 0 0.0 ACTHERIO 0 0.0 0 0.0 ACVA 0 0.0 0 0.0 ACVB 0 0.0 0 0.0 ACVCP 0 0.0 0 0.0 ACVD 0 0.0 0 0.0 ACVECC 1 0.1 0 0.0 ACVIM 1 0.1 3 2.3 ACVM 3 0.4 0 0.0 ACVN 0 0.0 0 0.0 ACVO 1 0.1 0 0.0 ACVPM 5 0.7 0 0.0 ACVR 0 0.0 0 0.0 ACVS 0 0.0 0 0.0 ACZM 1 0.1 0 0.0 AVDC 0 0.0 0 0.0 ABTOX 39 5.5 3 2.3 ECVP 10 1.4 0 0.0 ECVCP 0 0.0 4 3.0 One Certification Not Listed 25 3.5 5 3.8 Two Certifications Not Listed 1 0.1 0 0.0

* NOTE: Respondents could select more than one certification, so it is not reasonable to add the frequency or percent information. ACVP diplomates work with a wide variety of species, depending on the setting in which they are employed. Respondents were asked to use a five-point scale to describe the frequency with which they deal with the different species. The scale was presented as follows: How frequently do you deal with the following species? Please mark all that apply, using the following scale: 0 = Never (not at all) 1 = Rarely (once or twice per year) 2 = Sometimes (once or twice per month) 3 = Often (once or twice per week) 4 = Repetitively (three or more times per week)

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Table 4 presents the mean response for the species listed. Consistent with the scale employed, the higher the mean, the more frequently diplomates deal with the species. For veterinary anatomic pathologists, rodents and dogs are the most frequent species, while dog and cats are the most frequent for veterinary clinical pathologists. Table 4: Mean Frequency Estimates for Species

Anatomic Clinical Species

N

Mean Standard Deviation

N

Mean

Standard Deviation

Birds 635 1.0 1.2 128 1.6 1.2 Cats 631 1.5 1.6 128 3.1 1.5 Cows 627 1.1 1.5 127 1.7 1.2 Dogs 683 2.5 1.3 132 3. 0.8 Fish 628 0.6 0.8 127 0.6 0.7 Horses 631 1.2 1.4 127 2.4 1.5 Marine Mammals 620 0.4 0.8 127 0.6 0.8 Non-Human Primates 669 1.7 1.3 132 1.2 1.3 Pigs 645 1.1 1.1 127 0.8 0.7 Pocket Pets 620 0.7 1.0 126 1.3 1.0 Poultry 624 0.6 1.0 127 0.4 0.7 Rabbits 657 1.3 0.9 128 1.4 0.7 Reptiles and Amphibians 625 0.7 1.0 126 1.3 1.0 Rodents 697 2.7 1.3 132 2.0 1.2 Small Ruminants 634 1.1 1.3 127 1.3 1.0 Wildlife 631 0.9 1.2 127 1.0 0.9 Zoo Animals 625 0.8 1.2 126 1.2 1.0

Veterinary pathologists practice in diverse settings. The largest group of veterinary anatomic respondents practices in industry (363, of whom 291 work full time in industry), most frequently in the pharmaceutical sector (208, of whom 146 work full time in the pharmaceutical industry). An essentially equivalent group of veterinary anatomic respondents works in academic settings (351, of whom 141 work full time in academics). Veterinary clinical respondents work most frequently in academic settings (81, of whom 52 are full time in this setting), followed by diagnostic settings (49, of whom 23 are employed full time in this setting). The frequency information reported in Table 5a is the count of individual respondents who indicated that they spend some amount of time in the setting. The percent is relative to all respondents who answered the question (n = 714 for anatomic and n = 133 for clinical).

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Table 5a: Practice Setting—Frequency * Anatomic Clinical

Practice Setting Frequency Percent Frequency Percent

Academic 351 49.2 81 60.9 Teaching 282 39.5 70 52.6 Research 232 32.5 62 46.6 Clinical 163 22.8 58 43.6 Administration 200 28.0 50 37.6 Diagnostic 195 27.3 49 36.8 Government 81 11.3 6 4.5 Industry 363 50.8 39 29.3 Chemical 33 4.6 6 4.5 Pharmaceutical 208 29.1 25 18.8 Biotechnology 80 11.2 13 9.8 Contract 118 16.5 15 11.3 Medical Devices 38 5.3 9 6.8 Research 60 8.4 9 6.8 Private Practice 34 4.8 6 4.5 Non-practicing 29 4.1 0 0.0 Other 39 5.5 9 6.8

* NOTE: Respondents could select more than one practice setting, so it is not reasonable to add the frequency or percent information. Respondents next reported the percentage of the work week spent in various practice areas (see Table 5b). On average, the greatest amount of time is spent working in industry, with the pharmaceutical sector being more common for both anatomic and clinical respondents, followed by contract work. The second largest practice area was academic for both groups. The information reported in Table 5b is the mean percentage of the work week devoted to the practice setting.

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Table 5b: Descriptive Statistics for Percentage of Work Week in Practice Areas Anatomic Clinical

Practice Settings N

Mean

Standard Deviation

N

Mean

Standard Deviation

Academic 351 56.11 43.21 81 71.53 42.22 Teaching 282 18.02 16.22 70 27.77 17.34 Research 232 28.07 25.60 62 20.56 18.66 Clinical 163 25.28 22.11 58 29.50 17.82 Administration 200 17.61 20.59 50 17.28 18.97 Diagnostic 195 54.00 37.40 49 72.43 36.37 Government 81 52.58 46.51 6 4.17 10.21 Industry 363 89.62 28.10 39 82.10 35.74 Chemical 33 24.00 39.00 6 2.17 3.49 Pharmaceutical 208 84.01 30.90 25 67.96 41.84 Biotechnology 80 50.73 40.60 13 34.08 38.40 Contract 118 74.80 40.03 15 61.27 46.06 Medical Devices 38 32.82 41.45 9 14.22 23.43 Research 60 21.95 31.11 9 24.11 43.15 Private Practice 34 29.91 42.66 6 36.67 48.11 Non-practicing 29 17.59 35.32 3 0.00 0.00 Other 39 27.69 37.08 9 32.56 27.88

More than half (57.4%) of the veterinary anatomic pathologists responding to the survey report that they have an administrative and/or management role, and on average they spend 31.7% of their time in that role. Fewer respondents, but still more than half (51.1%), identified as veterinary clinical pathologists report such responsibilities, and they devote an average of 27.4% of their time to them. It should be noted, however, that the percent of time spent in an administrative and/or leadership role varies quite widely among respondents in both groups. Table 6: Administrative and/or Management Role

Anatomic Clinical Response Frequency Percent Frequency Percent

Yes 410 57.4 68 51.1 No 302 42.3 64 48.1 No Response 2 0.3 1 0.8 Total 714 100.0 133 100.00

Data in Table 7 provide the mean percent of time that respondents with an administrative and/or management role spend in that role. Eight veterinary anatomic respondents did not estimate time. Table 7: Percent of Time Spent in an Administrative and/or Management Role

Anatomic Clinical Frequency Mean Std Dev Frequency Mean Std Dev

Time Spent 402 31.7 28.4 68 27.4 21.4

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Also of interest is whether or not respondents offer leadership and/or have a role in training veterinary pathologists for board eligibility. Over one third of veterinary anatomic respondents have this responsibility, and they devote an average of 15.1 percent of their time to this work. Interestingly, more than half of the veterinary clinical pathologists responding to the survey indicate they offer leadership or have a role in training for board eligibility, and they spend 21.0 percent of their time in these areas. Table 8: Respondents Involved in Training Veterinary Pathologists for Board Eligibility


Yes 266 37.3 71 53.4 No 439 61.5 62 46.6 No Response 9 1.2 0 0 Total 714 100.0 133 100.0

Data in Table 9 provide the mean percent of time that respondents who are involved in training veterinary pathologists for board eligibility spend in that role. Ten veterinary anatomic respondents and 2 veterinary clinical respondents did not estimate time. Table 9: Percent of Time Spent in Training Veterinary Pathologists for Board Eligibility

Anatomic Clinical Frequency Mean Std Dev Frequency Mean Std Dev

Time Spent 256 15.1 14.5 69 21.0 17.9 The vast majority of respondents from both specialties report working full time, as shown in Table 10. Ten veterinary anatomic respondents reported being retired, even though retired members of ACVP were not included when the survey was distributed. Table 10: Full and Part Time Work Status


Yes 635 88.9 124 93.2 No 46 6.4 7 5.3 Retired 10 1.4 0 0 No Response 23 3.2 2 1.5 Total 714 100.0 133 100.0

Consistent with the allocation of time spent on administration and/or management, veterinary anatomic respondents report spending 72.5 percent of their time practicing veterinary pathology. Veterinary clinical respondents spend a little more time (79.4 percent) practicing veterinary pathology.

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Table 11: Percent of Time Spent Practicing Veterinary Pathology Anatomic Clinical

Frequenc

y Mean Std Dev Frequency Mean Std Dev

Time Spent 705 72.5 31.8 132 79.4 28.3 Respondents were asked to indicate the state, province, or international region in which they practice. This information is reported in Table 12. It is clear that veterinary pathologists are distributed reasonably, although there are concentrations in major research centers.

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Table 12: Primary State, Province, or International Region Anatomic Clinical Location

Frequency Percent Frequency Percent USA

Alaska 0 0.0 1 0.8 Arkansas 3 0.4 0 0.0 Alabama 12 1.7 2 1.5 Arizona 5 0.7 1 0.8 California 71 9.9 11 8.3 Colorado 14 2.0 8 6.0 Connecticut 29 4.1 2 1.5 District of Columbia 7 1.0 0 0.0 Delaware 2 0.3 0 0.0 Florida 7 1.0 2 1.5 Georgia 15 2.1 3 2.3 Hawaii 1 0.1 0 0.0 Iowa 10 1.4 2 1.5 Illinois 16 2.2 4 3.0 Indiana 35 4.9 5 3.8 Kansas 8 1.1 0 0.0 Kentucky 2 0.3 0 0.0 Louisiana 6 0.8 1 0.8 Massachusetts 34 4.8 5 3.8 Maryland 37 5.2 1 0.8 Maine 2 0.3 0 0.0 Michigan 22 3.1 5 3.8 Minnesota 10 1.4 1 0.8 Missouri 11 1.5 4 3.0 Mississippi 5 0.7 1 0.8 Montana 2 0.3 0 0.0 North Carolina 37 5.2 6 4.5 Nebraska 2 0.3 0 0.0 New Hampshire 2 0.3 0 0.0 New Jersey 28 3.9 3 2.3 New Mexico 2 0.3 0 0.0 Nevada 3 0.4 2 1.5 New York 18 2.5 6 4.5 Ohio 26 3.6 3 2.3 Oklahoma 8 1.1 4 3.0 Oregon 5 0.7 5 3.8 Pennsylvania 38 5.3 4 3.0 South Carolina 1 0.1 1 0.8 South Dakota 1 0.1 0 0.0 Tennessee 6 0.8 1 0.8 Texas 16 2.2 4 3.0 Utah 5 0.7 0 0.0 Virginia 15 2.1 2 1.5 Washington 23 3.2 4 3.0

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Table 12 (Continued): Primary State, Province, or International Region Anatomic Clinical Location


Wisconsin 18 2.5 3 2.3 West Virginia 2 0.3 0 0.0 Wyoming 2 0.3 0 0.0

Canada Alberta 4 0.6 1 0.8 British Columbia 3 0.4 3 2.3 Nova Scotia 1 0.1 0 0.0 Ontario 11 1.5 5 3.8 Prince Edward Island 2 0.3 1 0.8 Quebec 14 2.0 2 1.5 Saskatchewan 6 0.8 4 3.0

International Regions Africa 2 0.3 0 0.0 Asia/Pacific Islands 6 0.8 3 2.3 Australia 10 1.4 2 1.5 Europe 25 3.5 4 3.0 No Response 6 0.8 1 0.8 Total 714 100.0 133 100.0

The last item in the demographic portion of the survey requested that respondents identify their gender. Frequency information on that variable is presented in Table 13. Not quite two-thirds of the veterinary anatomic pathology respondents are male, and not quite two-thirds of the veterinary clinical pathology respondents are female. Table 13: Gender


Male 447 62.6 46 34.6 Female 265 37.1 86 64.7 No Response 2 0.3 1 0.8 Total 714 100.0 133 100.0

Validation of Veterinary Anatomic Pathologists’ Role Anatomic Elements of Practice The veterinary anatomic survey respondents were asked to evaluate each anatomic element of practice, task, foundational science, specific science, and tool, rating them using scales for point of acquisition, criticality, and frequency. A three-point scale was used for the point of acquisition scale. Five-point scales were used for criticality and frequency ratings, with a “4” representing the highest rating concerning the performance of the respondent. The scale anchors for point of acquisition, criticality, and frequency are listed below as a reference.

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Point of Acquisition Ratings Point of acquisition was defined as the time in the preparation of the veterinary anatomic pathologist at which knowledge in the element of practice is acquired. Participants were asked to evaluate each of the seven elements of practice using the scale below. Participants were asked to assign each element of practice only one estimate. The specific question used in the survey was: When would a new diplomate in veterinary anatomic pathology acquire the skills required within this element of practice in order to fill your current position?

0 = Not applicable.

1 = Expected of new diplomates.

2 = Acquired after board certification is earned.

Table 14 reports the number of respondents (count) selecting each option in the point of acquisition scale. Not all respondents completed the entire survey; consequently, the sum of the counts will vary from item to item. As is apparent from the data in Table 13, the largest number of veterinary anatomic respondents indicated that four elements of practice account for responsibilities expected of new diplomates in the anatomic pathology specialty: Research and Investigative Design, Data Collection, Data Analysis and Interpretation, and Communication and Reporting. This indicates that respondents believe new diplomates must acquire competence in these elements of practice prior to board certification. On the other hand, the largest group of respondents indicates that Quality Assurance, Public Health and Risk Management, and Education and Professional Development are elements of practice in which proficiency is expected only after board certification is earned.

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Table 14: Point of Acquisition for Anatomic Elements of Practice Elements of Practice: Point of Acquisition Scale

Rating1 Count Percent 0 76 11.8 1 336 52.3

I. Research and Investigative Design 2 231 35.9

0 26 4.2 1 477 77.1 II. Data Collection 2 116 18.7 0 17 2.9 1 431 72.8

III. Data Analysis and Interpretation

2 144 24.3 0 16 2.7 1 392 66.8

IV. Communication and Reporting

2 179 30.5 0 36 6.2 1 156 26.8 V. Quality Assurance 2 391 67.1 0 104 18.0 1 169 29.2

VI. Public Health and Risk Management

2 306 52.8 0 28 4.9 1 205 35.6

VII. Education and Professional Development 2 343 59.5

1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Criticality Ratings for Elements of Practice Given that ACVP certification identifies for the public and other stakeholders those individuals who are competent to practice veterinary pathology, the criticality scale addresses an essential issue — the potential for harmful consequences to occur if diplomates are not competent in the elements of practice. The specific question used in the survey was: To what degree would a veterinary anatomic pathologist's incompetent performance in each element of practice be seen as causing harm to the stakeholders? (Harm may be seen as physical, psychological, emotional, legal, financial, etc.) Please consider your current job and practice setting when responding.

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0 = No Harm or Not

Applicable Inability to perform tasks within this element of practice would lead to error with no adverse consequences, or not applicable.

1 = Minimal Harm Inability to perform tasks within this element of practice would lead to error with minimal adverse consequences.

2 = Moderate Harm Inability to perform tasks within this element of practice would lead to error with moderate adverse consequences.

3 = Substantial Harm Inability to perform tasks within this element of practice would lead to error with substantial adverse consequences.

4 = Extreme Harm Inability to perform tasks within this element of practice would lead to error with extreme adverse consequences.

Veterinary anatomic respondents, on average, attribute the greatest criticality to Communication and Reporting, followed closely by Data Analysis and Interpretation and by Data Collection, all three of which may be described as having potential for substantial harm. The other elements of practice were seen by veterinary anatomic respondents as having potential for moderate harm. Table 15: Criticality of Anatomic Elements of Practice

Element of Practice N

Mean1 SEM

Std. Dev.

I. Research and Investigative Design 635 2.12 0.05 1.16 II. Data Collection 611 2.65 0.04 1.01 III. Data Analysis and Interpretation 588 2.88 0.04 0.95 IV. Communication and Reporting 585 2.91 0.04 0.89 V. Quality Assurance 578 2.43 0.04 0.97 VI. Public Health and Risk Management 569 2.18 0.05 1.25 VII. Education and Professional Development 576 2.17 0.04 0.96

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm

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Figure 3: Mean Criticality by Anatomic Element of Practice

2.12

2.65

2.88 2.91

2.43

2.18 2.17

0

1

2

3

4

EP I EP II EP III EP IV EP V EP VI EP VI

RA

TIN

G

Frequency of Elements of Practice In addition to point of acquisition and criticality, the validation study addressed the frequency with which veterinary pathologists perform the elements of practice. Respondents were asked to think of frequency in the following way: Frequency refers to the time that diplomates in veterinary anatomic pathology [you] spend performing duties that require proficiency in each of the elements of practice, foundational sciences, or tasks. The following scale is used to record frequency for specific sciences and tasks: 0 = Never

Not responsible for this specific science or task.

1 = Rarely

About once per year.

2 = Sometimes

About once per month.

3 = Often

About once per week.

4 = Repetitively

About once or more per day.

The elements of practice with the highest frequency ratings for veterinary anatomic respondents are Communication and Reporting, Data Analysis and Interpretation, and Data Collection, in that order. Respondents report working in these elements of practice between once per week and once or more per

36



day. Even though Public Health and Risk Management has the lowest frequency rating, respondents work in that area between once per year and once per month. Table 16: Frequency of Anatomic Elements of Practice


Mean

1 SEM Std. Dev.


1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Figure 4: Mean Frequency by Anatomic Element of Practice

2.40

3.153.30 3.36

2.36

1.51

2.29

0

1

2

3

4

EP I EP II EP III EP IV EP V EP VI EP VII

RA

TIN

G

Tasks Within Anatomic Elements of Practice Within each element of practice for veterinary anatomic pathologists is a set of task statements that supply essential detail about the element of practice. In essence, task statements provide an operational definition of the element of practice by identifying what is done, how it is done, and why. Respondents were asked to evaluate each task using the point of acquisition, criticality, and frequency scales defined above. The following pages present the list of task statements followed by tables of descriptive statistics that account for the data.

37



Anatomic Element of Practice I: Research and Investigative Design A. Design experiments and diagnostic investigations by formulating hypotheses and applying basic

scientific principles in order to conduct studies and provide valid conclusions. B. Coordinate research and diagnostic investigations with collaborators or multidisciplinary teams using

knowledge of comparative pathophysiology in order to ensure valid experimental design and interpretation of results.

C. Develop investigational techniques in pathology and animal models of disease using knowledge of

materials and methods in order to answer scientific questions and provide diagnoses. D. Use animal models of disease by leveraging knowledge of comparative pathology, experimental

pathology, and translational research in order to improve human and animal health. Table 17: Point of Acquisition for Tasks Within Anatomic Element of Practice I (Research and Investigative Design)

Tasks Within Element of Practice I: Point of Acquisition Scale Rating1 Count Percent

0 100 14.3 1 375 53.6

Design experiments and diagnostic investigations

2 224 32.0 0 77 11.0 1 217 31.1

Coordinate research and diagnostic investigations

2 404 57.9 0 96 13.8 1 297 42.6

Develop investigational techniques

2 305 43.7 0 93 13.3 1 257 36.8

Use animal models of disease

2 348 49.9 1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Table 18: Criticality of Tasks Within Anatomic Element of Practice I (Research and Investigative Design)

Tasks Within Element of Practice I N Mean1 SEM

Std. Dev.

Design experiments and diagnostic investigations 695 2.08 0.05 1.20

Coordinate research and diagnostic investigations 694 2.21 0.04 1.16

Develop investigational techniques 692 1.88 0.04 1.13 Use animal models of disease 694 2.06 0.05 1.22


38



Table 19: Frequency of Tasks Within Anatomic Element of Practice I (Research and Investigative Design)


Std. Dev.

Design experiments and diagnostic investigations 697 2.24 0.05 1.32

Coordinate research and diagnostic investigations 696 2.41 0.05 1.28

Develop investigational techniques 694 1.97 0.05 1.28 Use animal models of disease 694 2.09 0.05 1.37

1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Anatomic Element of Practice II: Data Collection A. Review antemortem data and history using a systematic process in order to support the collection of

relevant samples. B. Guide sample collection through oral and written directions to clinicians, scientists, and technicians in

order to ensure representative and diagnostic quality specimens. C. Perform necropsies in accordance with established protocols and using professional judgment in order

to understand pathogenesis and/or diagnose disease. D. Collect gross morphometric data by weighing and measuring tissues, lesions, organs, whole animals,

and other specimens in order to perform quantitative data analysis. E. Collect specimens according to protocols or professional judgment for histology, cytology, and other

testing for subsequent analysis or archiving in order to preserve sample integrity. F. Describe gross and microscopic morphological observations using a systematic approach and

appropriate, specific medical terminology in order to provide a complete and accurate record. G. Photograph gross and microscopic observations using current technology in order to support

documentation, analysis, and publication. H. Select applicable histochemical, immunocytochemical, immunohistochemical, molecular and other

assays using professional judgment in order to understand pathogenesis or make accurate diagnoses. I. Perform morphometric and other analyses using tissue sections or images in order to provide

quantitative interpretations. J. Perform critical reviews of literature and data by referencing electronic and printed sources in order to

validate protocols and analyses.

39



Table 20: Point of Acquisition for Tasks Within Anatomic Element of Practice II (Data Collection) Tasks Within Element of Practice II: Point of Acquisition Scale

Rating1 Count Percent 0 29 4.3 1 525 77.3

Review antemortem data and history to collect relevant samples 2 125 18.4

0 26 3.8 1 486 71.6

Guide sample collection by others

2 167 24.6 0 37 5.5 1 525 77.4 Perform necropsies 2 116 17.1 0 51 7.5 1 478 70.5

Collect gross morphometric data

2 149 22.0 0 34 5.0 1 520 76.9 Collect specimens to

preserve sample integrity 2 122 18.0 0 17 2.5 1 516 76.2

Describe morphological observations

2 144 21.3 0 33 4.9 1 492 72.7

Photograph gross and microscopic observations

2 152 22.5 0 14 2.1 1 462 68.3 Select applicable assays 2 200 29.6 0 141 20.9 1 179 26.5

Perform microscopic, morphometric, analyses, quantitative interpretations 2 356 52.7

0 33 4.9 1 471 69.6

Perform critical reviews of literature and data

2 173 25.6 1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned

40



Table 21: Criticality of Tasks Within Anatomic Element of Practice II (Data Collection)

Tasks Within Element of Practice II N Mean1 SEM

Std. Dev.

Review antemortem data and history to collect relevant samples 675 2.48 0.04 1.02

Guide sample collection by others 674 2.52 0.04 1.00 Perform necropsies 675 2.66 0.04 1.10 Collect gross morphometric data 675 2.03 0.04 1.09 Collect specimens to preserve sample integrity 671 2.53 0.04 1.04 Describe morphological observations 674 2.85 0.04 1.00 Photograph gross and microscopic observations 674 1.62 0.04 0.95 Select applicable assays 672 2.22 0.04 0.95 Perform microscopic, morphometric analyses, quantitative interpretations 667 1.37 0.04 0.99

Perform critical reviews of literature and data 673 2.07 0.04 1.02 1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 22: Frequency of Tasks Within Anatomic Element of Practice II (Data Collection)


Std. Dev.


Guide sample collection by others 675 2.85 0.04 1.10 Perform necropsies 675 2.75 0.05 1.31 Collect gross morphometric data 675 2.24 0.05 1.35 Collect specimens to preserve sample integrity 673 2.73 0.05 1.30 Describe morphological observations 675 3.41 0.04 0.96 Photograph gross and microscopic observations 674 2.42 0.04 1.09 Select applicable assays 673 2.67 0.04 1.07 Perform microscopic, morphometric analyses, quantitative interpretations 668 1.26 0.04 1.07

Perform critical reviews of literature and data 674 2.55 0.04 1.04 1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Anatomic Element of Practice III: Data Analysis and Interpretation A. Evaluate tissue morphology through examination of gross, histologic, ultrastructural, and cytologic

specimens in order to characterize tissue responses or generate morphologic diagnoses. B. Refine the characterization of tissue responses to injury by evaluating specimens using specialized

microscopic techniques in order to increase understanding of the pathologic process. C. Interpret immunohistochemistry, immunocytochemistry, and in situ hybridization in the context of

morphology in order to characterize tissue responses.

41



D. Interpret advanced tissue-based cellular and molecular biology data in context of morphology in order to characterize mechanisms of tissue responses.

E. Integrate pathologic and epidemiological findings by applying understanding of disease mechanisms

in order to characterize the emergence and transmission of disease in human and animal populations. F. Integrate individual animal data by correlating clinical pathology, toxicology, diagnostic imaging,

microbiology, and other test results with morphology in order to characterize the pathogenesis of disease or formulate a diagnosis.

G. Interpret normal variations and common and spontaneous alterations and diseases using knowledge of

species, breed, strain, sex, and age in order to provide appropriate context for the significance of the findings.

H. Identify artifacts in tissue sections and other samples using professional judgment and expertise in

order to identify those that could be misinterpreted or impede the ability to assess the tissue response accurately.

I. Organize complete data sets from groups of animals, using or creating retrievable and analyzable

formats in order to enable statistical analyses, as appropriate, and characterize and interpret study results.

42



Table 23: Point of Acquisition for Tasks Within Anatomic Element of Practice III (Data Analysis and Interpretation)

Tasks Within Element of Practice III: Point of Acquisition Scale Rating1 Count Percent

0 12 1.8 1 519 79.0

Evaluate tissue morphology

2 126 19.2 0 49 7.5 1 318 48.6

Use special microscopic techniques

2 287 43.9 0 33 5.0 1 412 62.9

Interpret immunohisto-chemistry, histochem-istry, in situ immuno-chemistry and hybridization 2 210 32.1

0 103 15.8 1 198 30.3

Interpret advanced tissue-based cellular and molecular biology data 2 352 53.9

0 117 17.9 1 274 41.9

Integrate pathologic and epidemiological findings

2 263 40.2 0 23 3.5 1 444 67.8

Integrate individual animal data

2 188 28.7 0 12 1.8 1 418 63.9

Interpret normal variations and spontaneous findings 2 224 34.3

0 10 1.5 1 496 75.7

Identify artifacts in tissue sections and other samples 2 149 22.7

0 68 10.4 1 198 30.3

Organize complete data sets for study analysis


43



Table 24: Criticality of Tasks Within Anatomic Element of Practice III (Data Analysis and Interpretation)

Tasks Within Element of Practice III N Mean1 SEM

Std. Dev.

Evaluate tissue morphology 652 3.11 0.03 0.89 Use special microscopic techniques 649 2.06 0.04 1.08 Interpret immunohistochemistry, histochemistry, in situ immunochemistry and hybridization

650 2.24 0.04 0.94

Interpret advanced tissue-based cellular and molecular biology data 647 1.75 0.04 1.08

Integrate pathologic and epidemiological findings 644 1.99 0.05 1.25

Integrate individual animal data 650 2.67 0.04 0.96 Interpret normal variations and spontaneous findings 649 2.66 0.04 0.95

Identify artifacts in tissue sections and other samples 651 2.58 0.04 0.99

Organize complete data sets for study analysis 648 2.14 0.04 1.12 1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 25: Frequency of Tasks Within Anatomic Element of Practice III (Data Analysis and Interpretation)


Std. Dev.

Evaluate tissue morphology 653 3.59 0.03 0.80 Use special microscopic techniques 649 2.06 0.05 1.19 Interpret immunohistochemistry, histochemistry, in situ immunochemistry and hybridization

651 2.24 0.04 1.15

Interpret advanced tissue-based cellular and molecular biology data 646 1.56 0.05 1.20

Integrate pathologic and epidemiological findings 643 1.38 0.05 1.21

Integrate individual animal data 650 2.98 0.04 1.05 Interpret normal variations and spontaneous findings 650 3.21 0.04 0.93

Identify artifacts in tissue sections and other samples 652 3.24 0.04 0.91

Organize complete data sets for study analysis 648 2.26 0.05 1.32 1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day

44



Anatomic Element of Practice IV: Communication and Reporting A. Communicate pathology findings and their significance through clear and concise oral and written

reports to regulators, clinicians, scientists, and other stakeholders in order to provide appropriate context for decision making.

B. Communicate information about animal disease, diagnosis, and pathogenesis to the public through

consultation and appropriate media in order to inform it of health risks. C. Discuss scientific findings by participating in public forums, hearings, or confidential meetings in

order to educate regulators, governmental officials, and the general public. D. Publish scientific findings in peer reviewed literature by authoring manuscripts in order to educate the

profession and society. E. Disseminate knowledge by authoring articles, abstracts, reports, and proceedings, and by making

presentations at scientific meetings in order to educate the profession, scientific community, and the general public.

F. Testify as an expert witness or as the pathologist of record by responding to legal requests and

proceedings in order to furnish evidence, interpret findings, and provide professional opinion. Table 26: Point of Acquisition for Tasks Within Anatomic Element of Practice IV (Communication and Reporting)

Tasks Within Element of Practice IV: Point of Acquisition Scale Rating1 Count Percent

0 7 1.1 1 421 65.4

Communicate pathology findings and their significance to clinicians, regulators, and scientists 2 216 33.5

0 154 24.0 1 165 25.7

Communicate animal disease to the public.

2 324 50.4 0 97 15.1 1 104 16.1

Discuss scientific findings in public forums to educate stakeholders 2 443 68.8

0 29 4.5 1 408 63.4

Publish scientific findings in peer reviewed literature 2 207 32.1

0 35 5.4 1 399 62.0

Disseminate knowledge through publications, abstracts, reports, and presentations, 2 210 32.6

0 147 22.8 1 47 7.3

Testify as an expert witness or as the pathologist of record 2 450 69.9

1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned

45



Table 27: Criticality of Tasks Within Anatomic Element of Practice IV (Communication and Reporting)

Tasks Within Element of Practice IV N Mean1 SEM

Std. Dev.

Communicate pathology findings and their significance to clinicians, regulators, and scientists

641 3.10 0.03 0.82

Communicate animal disease to the public 631 2.18 0.06 1.42 Discuss scientific findings in public forums to educate stakeholders 636 2.21 0.05 1.26

Publish scientific findings in peer reviewed literature. 642 1.90 0.04 1.04

Disseminate knowledge through publications, abstracts, reports, and presentations 643 1.86 0.04 1.00

Testify as an expert witness or as the pathologist of record 630 2.18 0.06 1.43

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 28: Frequency of Tasks Within Anatomic Element of Practice IV (Communication and Reporting)


Std. Dev.

Communicate pathology findings and their significance to clinicians, regulators, and scientists

641 3.56 0.03 0.72

Communicate animal disease to the public 629 1.26 0.05 1.27 Discuss scientific findings in public forums to educate stakeholders 635 1.37 0.04 1.02

Publish scientific findings in peer reviewed literature. 643 1.75 0.04 0.90

Disseminate knowledge through publications, abstracts, reports, and presentations 644 1.81 0.04 0.91

Testify as an expert witness or as the pathologist of record 630 0.66 0.03 0.81

1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Anatomic Element of Practice V: Quality Assurance A. Conduct reviews of research designs, proposals, results, and manuscripts in accordance with the

scientific method in order to ensure correct interpretation of results and conclusions. B. Supervise technical staff by providing training and oversight in order to ensure consistent quality and

compliance with applicable internal and external regulations and standards.

46



C. Conduct pathology peer review in accordance with standard operating procedure or accepted standards of practice in order to ensure consistency in identification, grading, and terminology for findings.

D. Resolve discrepancies derived from pathology peer reviews using a pathology working group or

involving internal or external sources of expertise in order to achieve consensus. E. Ensure that laboratory procedures provide meaningful results in accordance with standard operating

procedures or scientific principles in order to ensure reproducibility and validity. F. Author standard operating procedures in accordance with prescribed methods in order to ensure

acceptable levels of quality and consistency. G. Conduct laboratory inspections in accordance with standard operating procedure, regulations, and

professional standards in order to ensure acceptable levels of quality and consistency. Table 29: Point of Acquisition for Tasks Within Anatomic Element of Practice V (Quality Assurance)

Tasks Within Element of Practice V: Point of Acquisition Scale Rating1 Count Percent

0 63 9.9 1 184 28.9

Conduct reviews of designs, proposals, results, and manuscripts 2 389 61.2

0 74 11.6 1 104 16.3 Supervise technical staff 2 459 72.1 0 82 12.9 1 57 8.9

Conduct pathology peer review

2 498 78.2 0 121 19.0 1 46 7.2

Resolve discrepancies using pathology working groups and external experts 2 470 73.8

0 84 13.2 1 146 22.9

Provide results in accordance with SOPs or scientific principles 2 407 63.9

0 11 17.4 1 82 12.9

Author standard operating procedures

2 444 69.7 0 193 30.3 1 55 8.6

Conduct laboratory inspections


47



Table 30: Criticality of Tasks Within Anatomic Element of Practice V (Quality Assurance)

Tasks Within Element of Practice V N Mean1 SEM

Std. Dev.

Conduct reviews of designs, proposals, results, and manuscripts 632 2.18 0.04 1.05

Supervise technical staff 628 2.20 0.04 1.07 Conduct pathology peer review 625 2.21 0.05 1.14 Resolve discrepancies using pathology working groups and external experts 623 1.90 0.05 1.23

Provide results in accordance with SOPs or scientific principles 628 2.27 0.04 1.11

Author standard operating procedures 627 1.88 0.04 1.11 Conduct laboratory inspections 621 1.60 0.05 1.23

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 31: Frequency of Tasks Within Anatomic Element of Practice V (Quality Assurance)


Std. Dev.


Supervise technical staff 627 2.09 0.05 1.21 Conduct pathology peer review 625 1.81 0.05 1.21 Resolve discrepancies using pathology working groups and external experts 622 1.23 0.04 1.08

Provide results in accordance with SOPs or scientific principles 628 1.88 0.05 1.21

Author standard operating procedures 626 1.31 0.04 1.05 Conduct laboratory inspections 620 0.88 0.04 1.01

1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Anatomic Element of Practice VI: Public Health and Risk Assessment Within Human and Animal Populations A. Monitor disease prevalence and trends within assigned populations by maintaining and querying

existing databases and through professional networking in order to detect shifts and disease incidence that might indicate an emerging disease threat.

B. Recognize novel manifestations of disease through knowledge of disease prevalence and trends,

pathological evaluations, and literature review in order to detect emerging diseases. C. Train veterinarians, veterinary students, and the public through oral and written communication to

recognize clinical signs and lesions in order to aid in detection of disease threats. D. Detect diseases of importance to public or animal health by evaluating sentinel animals or wildlife

populations, performing necropsies, collecting appropriate specimens, and analyzing environmental threats in collaboration with other scientists in order to characterize disease threats.

48



E. Report disease occurrence in compliance with regulatory requirements or guidelines in order to maintain adequate information to serve the public’s needs.

F. Develop rational disease mitigation strategy by assessing risk and applying understanding of

environmental conditions, host /agent interactions, and animal populations in order to minimize the impact of disease.

G. Characterize pharmacologic and toxicologic responses in animals by performing pathologic

assessments of tissues and other samples in order to determine efficacious and safe exposure and to provide appropriate risk assessment.

H. Integrate animal disease information with animal population management by applying understanding

of disease mechanisms in animals in order to provide insight on risk assessment for people and animal populations.

Table 32: Point of Acquisition for Tasks Within Anatomic Element of Practice VI (Public Health and Risk Management)

Tasks Within Element of Practice VI: Point of Acquisition Scale Rating1 Count Percent

0 215 34.4 1 109 17.4

Monitor disease trends using databases and networking 2 301 48.2

0 140 22.4 1 196 31.4

Recognize novel manifestations of disease

2 289 46.2 0 175 28.0 1 139 22.2

Train others to detect disease threats

2 311 49.8 0 176 28.2 1 203 32.5

Detect diseases that threaten public or animal health 2 246 39.4

0 185 29.6 1 203 32.5 Report disease

occurrence 2 237 37.9 0 232 37.1 1 116 18.6

Develop rational disease mitigation strategy

2 277 44.3 0 128 20.4 1 90 14.3

Characterize responses in animals to provide risk assessment 2 410 65.3

0 192 30.7 1 120 19.2

Integrate animal disease and population manage-ment information to improve risk assessment 2 313 50.1


49



Table 33: Criticality of Tasks Within Anatomic Element of Practice VI (Public Health and Risk Management)

Tasks Within Element of Practice VI N Mean1 SEM

Std. Dev.

Monitor disease trends using databases and networking 608 1.64 0.05 1.33

Recognize novel manifestations of disease 613 2.00 0.05 1.29 Train others to detect disease threats 612 1.75 0.05 1.28 Detect diseases that threaten public or animal health 609 1.94 0.06 1.40

Report disease occurrence 612 2.03 0.06 1.46 Develop rational disease mitigation strategy 607 1.67 0.06 1.36 Characterize responses in animals to provide risk assessment 618 2.42 0.06 1.38

Integrate animal disease and population management information with animal population management

609 1.77 0.05 1.32

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 34: Frequency of Tasks Within Anatomic Element of Practice VI (Public Health and Risk Management)


Std. Dev.

Monitor disease trends using databases and networking 608 0.86 0.04 1.08

Recognize novel manifestations of disease 614 1.10 0.04 1.02 Train others to detect disease threats 613 1.25 0.05 1.29 Detect diseases that threaten public or animal health 610 1.10 0.05 1.20

Report disease occurrence 613 0.94 0.04 1.08 Develop rational disease mitigation strategy 607 0.65 0.04 0.91 Characterize responses in animals to provide risk assessment 618 2.00 0.06 1.59

Integrate animal disease and population management information with animal population management

609 1.04 0.05 1.21

1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day

50



Anatomic Element of Practice VII: Education and Professional Development A. Conduct reviews of research designs, proposals, results, and manuscripts in accordance with the

scientific method in order to provide constructive criticism, enhance the quality of research, and improve the utilization of research resources.

B. Educate regulators, other scientists, and officials about veterinary pathology using professional

training and expertise in order to share knowledge about animal disease recognition and pathogenesis. C. Serve as an expert consultant by applying the knowledge of comparative pathology in order to

respond to animal disease inquiry and advance human and animal health. D. Instruct undergraduate, professional, and graduate students, postgraduate veterinarians, and peers in

the discipline of pathology through lectures, laboratories, discussions, clinical service, mentoring, and other educational means in order to impart knowledge and advance the profession’s role in society.

E. Promote personal and professional development by consulting with pathologists, other scientists,

regulators, other professionals, and the public sector about veterinary pathology and by attending scientific meetings, seminars and workshops in order to enhance professional skills.

F. Mentor students, residents, and pathologists using experience and knowledge about organizations and

career opportunities in order to enhance the professional development of the individual and strengthen the profession.

G. Train technical staff, students, residents, professional peers and other professionals in the skills and

procedures of veterinary pathology by using knowledge, skills and experience in order to impart technical proficiency.

H. Train personnel in appropriate specimen handling using standard protocols, experience, professional

judgment, institutional policies and other information in order to minimize exposure of personnel and the environment to hazards.

I. Serve on professional and scientific committees by contributing professional knowledge and

experience in order to promote and improve the profession and benefit society. J. Model the responsible conduct of research through instruction, mentoring, and professional behavior

in order to maintain the integrity of the scientific process and the practice of veterinary medicine and pathology.

K. Mentor graduate students and postdoctoral trainees in research by directing and facilitating the

creation of research ideas, experimental design, laboratory experiences, and the dissemination of findings in order to develop new investigators.

51



Table 35: Point of Acquisition for Tasks Within Anatomic Element of Practice VII (Education and Professional Development)


0 65 10.6 1 164 26.8


0 103 16.9 1 103 16.9

Educate regulators, other scientists, and officials

2 405 66.3 0 125 20.5 1 65 10.6

Serve as an expert consultant

2 421 68.9 0 79 12.9 1 171 27.9

Instruct professionals to advance the discipline of pathology 2 362 59.2

0 24 3.9 1 296 48.3

Promote personal and professional development

2 293 47.8 0 83 13.6 1 101 16.5

Mentor others regarding organizations and career opportunities 2 428 69.9

0 49 8.0 1 171 27.9

Train others in veterinary pathology to impart technical proficiency 2 392 64.1

0 77 12.6 1 218 35.7

Train personnel in safe specimen handling

2 316 51.7 0 111 18.2 1 50 8.2

Serve on professional and scientific committees

2 450 73.6 0 96 15.7 1 192 31.4

Model the responsible conduct of research

2 323 52.9 0 182 29.8 1 56 9.2

Mentor graduate students and postdoctoral trainees in research 2 373 61.0


52



Table 36: Criticality of Tasks Within Anatomic Element of Practice VII (Education and Professional Development)

Tasks Within Element of Practice VII N Mean1 SEM

Std. Dev.


Educate regulators, other scientists, and officials 604 1.73 0.04 1.08 Serve as an expert consultant 604 1.87 0.05 1.22 Instruct professionals to advance the discipline of pathology 605 1.82 0.04 1.09

Promote personal and professional development 611 1.78 0.04 1.02 Mentor others regarding organizations and career opportunities 604 1.62 0.04 1.08

Train others in veterinary pathology to impart technical proficiency 606 1.88 0.04 1.00

Train personnel in safe specimen handling 606 2.10 0.05 1.13 Serve on professional and scientific committees 607 1.37 0.04 1.02 Model the responsible conduct of research 601 2.00 0.05 1.21 Mentor graduate students and postdoctoral trainees in research 598 1.49 0.05 1.23


53



Table 37: Frequency of Tasks Within Anatomic Element of Practice VII (Education and Professional Development)


Std. Dev.


Educate regulators, other scientists, and officials 604 1.47 0.04 1.07 Serve as an expert consultant 604 1.25 0.04 1.10 Instruct professionals to advance the discipline of pathology 606 1.92 0.05 1.34

Promote personal and professional development 613 2.27 0.04 0.91 Mentor others regarding organizations and career opportunities 606 1.87 0.05 1.17

Train others in veterinary pathology to impart technical proficiency 607 2.06 0.05 1.11

Train personnel in safe specimen handling 607 1.82 0.05 1.15 Serve on professional and scientific committees 607 1.37 0.04 1.04 Model the responsible conduct of research 602 1.99 0.05 1.34 Mentor graduate students and postdoctoral trainees in research 599 1.11 0.05 1.19

1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Anatomic Foundational Sciences Veterinary anatomic pathologists used the same scales (point of acquisition, criticality, and frequency) in evaluating the foundational sciences—topics that undergird the ability of the veterinary anatomic pathologist to perform competently in the elements of practice and tasks. Tables 37 through 39 summarize the data.

54



Table 38: Point of Acquisition for Anatomic Foundational Sciences Frequency Analysis for Foundational Sciences: Acquisition Scale

Rating1 Frequency Percent 0 10 1.7 1 532 89.9

Anatomy and Physiology

2 50 8.4 0 16 2.7 1 532 90.6 Biology 2 39 6.6 0 36 6.2 1 517 88.4 Physical Sciences 2 32 5.5 0 48 8.2 1 415 70.9

Applied Mathematics and Statistics 2 122 20.9

0 16 2.7 1 469 80.6 Medicine 2 97 16.7 0 11 1.9 1 523 89.6 Pathology 2 50 8.6 0 31 5.3 1 507 87.1

Microbiology and Infectious Disease

2 44 7.6 1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Table 39: Criticality of Anatomic Foundational Sciences

Foundational Science N

Mean1 SEM

Std. Dev.

I. Anatomy and Physiology 588 3.05 0.04 0.92 II. Biology 583 2.33 0.04 1.05 III. Physical Sciences 580 1.62 0.04 0.91 IV. Applied Mathematics and Statistics 582 1.70 0.04 0.92 V. Medicine 579 2.57 0.04 0.92 VI. Pathology 581 3.34 0.03 0.80 VII. Microbiology and Infectious Disease 577 2.31 0.04 1.07


55



Figure 5: Mean Criticality by Anatomic Foundational Science

2.33

1.621.70

2.57

3.34

2.31

3.05

0

1

2

3

4

FS I FS II FS III FS IV FS V FS VI FS VII

RA

TIN

G

Table 40: Frequency of Anatomic Foundational Sciences

Foundational Sciences N

Mean1 SEM

Std. Dev.



56



Figure 6: Mean Frequency by Anatomic Foundational Science

3.50

2.78

1.801.86

2.88

3.74

2.41

0

1

2

3

4


RA

TIN

G

Specific Sciences Within Anatomic Foundational Sciences Specific Sciences are topics organized within the foundational sciences. The only scale used to evaluate them was criticality, and the data are presented in Tables 40 through 46. Table 41: Criticality of Specific Sciences in Anatomic Foundational Science I: Anatomy and Physiology

Specific Sciences N Mean1 SEM

Std. Dev.

Macroscopic Anatomy 620 2.84 0.04 0.95 Microscopic Anatomy 620 3.34 0.03 0.82

• Histology 620 3.15 0.04 0.93 • Cytology 619 1.79 0.04 1.10 • Ultrastructure 620 1.62 0.04 1.04

Physiology 620 2.39 0.04 1.00 Immunology 620 2.18 0.04 0.94


57



Table 41: Criticality of Specific Sciences in Anatomic Foundational Science II: Biology


Std. Dev.

Zoology 616 1.55 0.04 1.01 Cell and Molecular Biology 615 2.32 0.04 1.01 Developmental Biology 616 1.76 0.04 0.91 Genetics 616 1.70 0.04 0.95 Ecology 616 1.09 0.04 0.87

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 42: Criticality of Specific Sciences in Anatomic Foundational Science III: Physical Sciences


Std. Dev.

Biochemistry 613 1.91 0.04 1.00 Organic Chemistry 613 1.29 0.04 0.88 Inorganic Chemistry 612 1.11 0.03 0.83 Physics 613 0.87 0.03 0.81

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 43: Criticality of Specific Sciences in Anatomic Foundational Science IV: Applied Mathematics and Statistics


Std. Dev.

Biostatistics 614 1.82 0.04 1.03 Bioinformatics 614 1.23 0.04 0.94 Epidemiology 614 1.42 0.04 1.03

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 44: Criticality of Specific Sciences in Anatomic Foundational Science V: Medicine


Std. Dev.

Pharmacology 614 2.01 0.04 1.05 Toxicology 614 2.62 0.04 0.97 Diagnostic Imaging 614 1.40 0.04 0.91 Comparative Medicine 614 2.39 0.04 1.01


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Table 45: Criticality of Specific Sciences in Anatomic Foundational Science VI: Pathology


Std. Dev.

General Pathology 614 3.15 0.04 0.91 Systemic Pathology 614 3.34 0.03 0.79 Clinical Pathology 613 2.57 0.04 0.99 Cell and Molecular Pathology 614 2.43 0.04 1.05

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 46: Criticality of Specific Sciences in Anatomic Foundational Science VII: Microbiology and Infectious Disease


Std. Dev.

Virology 610 2.21 0.04 1.10 Bacteriology 610 2.23 0.04 1.09 Mycology 610 1.87 0.04 1.06 Parasitology 610 1.92 0.04 1.05

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Anatomic Tools Veterinary anatomic pathologists employ tools in their practice. Knowing which tools are used on a routine basis provides insight that ACVP may use in different ways. Veterinary anatomic respondents were asked to evaluate the tools using the point of acquisition, criticality, and frequency scales. Table 47: Point of Acquisition for Anatomic Tools

Frequency Analysis for Tools: Acquisition Scale Rating1 Frequency Percent Histology/Cytology

0 8 1.3 1 528 87.7

Light Microscopy (Standard HE)

2 66 11.0 0 86 14.3 1 438 72.9

Cytology (standard Wright-Giemsa)

2 77 12.8 0 18 3.0 1 498 82.9

Histochemistry/ Cytochemistry (Special Stains) 2 85 14.1

0 24 4.0 1 433 72.0

Immunohistochemistry /Immunocytochemistry

2 144 24.0 0 181 30.1 1 202 33.6 In Situ Hybridization 2 218 36.3


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Table 47 (Continued): Point of Acquisition for Anatomic Tools Frequency Analysis for Tools: Acquisition Scale

Rating1 Frequency Percent 0 49 8.1 1 421 69.9 Photomicroscopy 2 132 21.9

Clinical Pathology 0 61 10.2 1 470 78.3

Clinical Chemistry Interpretation

2 69 11.5 0 65 10.9 1 472 78.8

Hematology Interpretation

2 62 10.4 0 84 14.0 1 449 74.8

Urinalysis Interpretation

2 67 11.2 0 334 55.7 1 153 25.5

Clinical Chemistry Analyzers

2 113 18.8 0 346 57.7 1 145 24.2

Hematology Analyzers

2 109 18.2 0 369 61.5 1 128 21.3

Coagulation Analyzers

2 103 17.2 0 375 62.5 1 132 22.0 Blood Gas Analyzers 2 93 15.5 0 359 59.8 1 114 19.0

Immunoassay Analyzers

2 127 21.2 Special Microscopy Techniques

0 183 30.5 1 237 39.5

Fluorescence Microscopy

2 180 30.0 0 121 20.2 1 374 62.3

Transmission Electron Microscopy

2 105 17.5 0 319 53.2 1 107 17.8

Immunoelectron Microscopy

2 174 29.0 0 255 42.5 1 196 32.7

Scanning Electron Microscopy


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Rating1 Frequency Percent 0 281 46.8 1 101 16.8 Confocal Microscopy 2 218 36.3 0 289 48.2 1 74 12.3

Computer-Aided Slide Analysis

2 237 39.5 0 413 68.8 1 45 7.5 Intravital Microscopy 2 142 23.7

Other Investigational Techniques/Tools

0 335 55.8 1 94 15.7

Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) 2 171 28.5

0 262 43.7 1 102 17.0

Computer-Based Image Analysis

2 236 39.3 0 414 69.0 1 24 4.0

Computer Modeling of Biological System/ Organisms/Organs 2 162 27.0

0 268 44.7 1 130 21.7 Flow Cytometry 2 202 33.7 0 303 50.5 1 59 9.8

Laser Capture Microdissection

2 238 39.7 0 364 60.7 1 91 15.2 Spectrophotometry 2 145 24.2 0 293 48.8 1 149 24.8 Cell Culture 2 158 26.3 0 247 41.2 1 75 12.5

Telepathology

2 278 46.3 0 383 63.9 1 44 7.3

In Vivo Imaging (e.g., bioluminescence)


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Rating1 Frequency Percent Biochemical and Molecular Techniques/Tools

0 178 29.7 1 218 36.3

PCR and Related Molecular Techniques

2 204 34.0 0 303 50.5 1 84 14.0 Gene Microarray 2 213 35.5 0 362 60.3 1 63 10.5 Protein Microarray 2 175 29.2 0 326 54.3 1 80 13.3 Tissue Microarray 2 194 32.3 0 362 60.3 1 85 14.2

Gene Regulation/ Mutagenesis

2 153 25.5 0 280 46.7 1 145 24.2

Western Blotting and Related Proteomic Techniques 2 175 29.2

0 367 61.2 1 70 11.7 FISH/Cytogenetics 2 163 27.2 0 241 40.2 1 202 33.7

Immunoassays (Radio- immunodiffusion Assays, ELISA, etc.) 2 157 26.2

0 350 58.3 1 157 26.2 pH Assays 2 93 15.5 0 300 50.0 1 170 28.3 Electrophoresis 2 130 21.7


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Table 48: Criticality of Anatomic Tools

Tools N Mean1 SEM

Std. Dev.

Histology/Cytology Light Microscopy (Standard HE) 600 3.5 0.0 0.8 Cytology (standard Wright-Giemsa) 594 1.8 0.0 1.1 Histochemistry/Cytochemistry (Special Stains) 597 2.4 0.0 1.0 Immunohistochemistry/Immunocytochemistry 597 2.4 0.0 1.0 In Situ Hybridization 594 1.3 0.0 1.1 Photomicroscopy 598 1.6 0.0 1.1 Clinical Pathology Clinical Chemistry Interpretation 597 2.3 0.0 1.2 Hematology Interpretation 595 2.2 0.0 1.1 Urinalysis Interpretation 593 1.8 0.0 1.1 Clinical Chemistry Analyzers 587 0.9 0.0 1.1 Hematology Analyzers 586 0.8 0.0 1.1 Coagulation Analyzers 586 0.7 0.0 1.1 Blood Gas Analyzers 586 0.8 0.0 1.1 Immunoassay Analyzers 588 0.8 0.0 1.1 Special Microscopy Techniques Fluorescence Microscopy 590 1.2 0.0 1.1 Transmission Electron Microscopy 594 1.5 0.0 1.1 Immunoelectron Microscopy 586 0.7 0.0 0.9 Scanning Electron Microscopy 588 0.8 0.0 0.9 Confocal Microscopy 588 0.8 0.0 1.0 Computer-Aided Slide Analysis 587 0.8 0.0 1.0 Intravital Microscopy 584 0.5 0.0 0.8 Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) 585 0.7 0.0 1.0

Computer-Based Image Analysis 587 0.9 0.0 1.0 Computer Modeling of Biological System/ Organisms/Organs 585 0.4 0.0 0.8

Flow Cytometry 587 0.9 0.0 1.0 Laser Capture Microdissection 586 0.7 0.0 1.0 Spectrophotometry 586 0.5 0.0 0.8 Cell Culture 585 0.7 0.0 1.0 Telepathology 588 0.8 0.0 0.9 In Vivo Imaging (e.g., bioluminescence) 584 0.5 0.0 0.9 Biochemical and Molecular Techniques/ Tools

PCR and Related Molecular Techniques 590 1.3 0.0 1.2 Gene Microarray 586 0.7 0.0 1.0 Protein Microarray 586 0.5 0.0 0.9 Tissue Microarray 586 0.7 0.0 0.9 Gene Regulation/Mutagenesis 585 0.6 0.0 1.0


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Table 48 (Continued): Criticality of Anatomic Tools

Tools N Mean1 SEM

Std. Dev.

Western Blotting and Related Proteomic Techniques 586 0.8 0.0 1.0

FISH/Cytogenetics 582 0.5 0.0 0.8 Immunoassays (Radioimmunodiffusion Assays, ELISA, etc.) 588 1.0 0.0 1.0

pH Assays 584 0.6 0.0 0.9 Electrophoresis 584 0.7 0.0 0.9

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 49: Frequency of Anatomic Tools

Tools N Mean1 SEM

Std. Dev.

Histology/Cytology Light Microscopy Standard HE 599 3.7 0.0 0.7 Cytology (standard Wright-Giemsa) 594 1.6 0.1 1.2 Histochemistry/Cytochemistry(Special Stains) 597 2.5 0.0 1.1 Immunohistochemistry/Immunocytochemistry 596 2.4 0.0 1.1 In Situ Hybridization 594 0.7 0.0 0.9 Photomicroscopy 597 2.3 0.0 1.1 Clinical Pathology Clinical Chemistry Interpretation 596 2.2 0.0 1.2 Hematology Interpretation 594 2.1 0.0 1.2 Urinalysis Interpretation 593 1.8 0.1 1.2 Clinical Chemistry Analyzers 586 0.6 0.0 1.0 Hematology Analyzers 585 0.6 0.0 1.0 Coagulation Analyzers 585 0.4 0.0 0.9 Blood Gas Analyzers 585 0.3 0.0 0.8 Immunoassay Analyzers 587 0.5 0.0 0.9 Special Microscopy Techniques Fluorescence Microscopy 590 0.9 0.0 1.0 Transmission Electron Microscopy 594 1.0 0.0 0.8 Immunoelectron Microscopy 586 0.3 0.0 0.5 Scanning Electron Microscopy 588 0.5 0.0 0.7 Confocal Microscopy 588 0.5 0.0 0.8 Computer-Aided Slide Analysis 587 0.6 0.0 0.9 Intravital Microscopy 584 0.2 0.0 0.5


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Table 49 (Continued): Frequency of Anatomic Tools

Tools N Mean1 SEM

Std. Dev.

Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) 584 0.5 0.0 0.8



PCR and Related Molecular Techniques 589 1.2 0.0 1.2 Gene Microarray 585 0.5 0.0 0.8 Protein Microarray 585 0.3 0.0 0.6 Tissue Microarray 585 0.4 0.0 0.8 Gene Regulation/Mutagenesis 584 0.4 0.0 0.8 Western Blotting and Related Proteomic Techniques 585 0.6 0.0 0.9




Validation of Veterinary Clinical Pathologists’ Roles Clinical Elements of Practice Veterinary clinical pathology respondents were asked to evaluate the elements of practice, tasks, foundational sciences, specific sciences, and tools in a survey that paralleled that given to the veterinary anatomic pathology respondents, in that the same scales (point of acquisition, criticality, and frequency) were used. The six elements of practice in veterinary clinical pathology are the same as those for veterinary anatomic pathology, with the exception of the second, which is the combination of the second and third elements of practice for veterinary anatomic pathology. Point of Acquisition Ratings Point of Acquisition was defined as the point in the preparation of the veterinary pathologist at which knowledge in the element of practice, task, foundational science or tool is acquired. Participants were asked to use the scale below. Participants were asked to assign each element of practice only one estimate. The specific question used in the survey was:

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When would a new diplomate in veterinary clinical pathology acquire the skills required within this element of practice, task, foundational science, or tool in order to fill your current position?

0 = Not Applicable.

1 = Expected of new diplomates.

2 = Acquired after Board certification is earned.

Veterinary clinical pathology respondents indicate that new diplomates are expected to have gained competence in all six elements of practice at the time of their initial board certification (see Table 50). Not all respondents completed the entire survey, so the total count for each element of practice may differ. Table 50: Point of Acquisition for Clinical Elements of Practice

Elements of Practice: Point of Acquisition Scale Rating1 Count Percent

0 14 11.3 1 84 67.7


0 0 0.0 1 101 84.2

II. Data Collection, Analysis, and Interpretation 2 19 15.8

0 1 0.9 1 95 81.9

III. Communication and Reporting

2 20 17.2 0 4 3.5 1 73 64.0 IV. Quality Assurance 2 37 32.5 0 17 15.2 1 50 44.6

V. Public Health and Risk Management

2 45 40.2 0 7 6.4 1 64 58.2

VI. Education and Professional Development 2 39 35.5

1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Criticality Ratings Addressing a topic at the heart of certification, the Criticality scale focuses on the potential for harmful consequences to occur if diplomates are not competent in the elements of practice. The specific question used in the survey was: To what degree would a veterinary clinical pathologist's incompetent performance in each element of practice be seen as causing harm to the stakeholders? (Harm may be seen as physical, psychological, emotional, legal, financial, etc.) Please consider your current job and practice setting when responding.

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0 = No Harm or Not Applicable

Inability to perform tasks within this element of practice would lead to error with no adverse consequences, or not applicable.

1 = Minimal Harm Inability to perform tasks within this element of practice would lead to error with minimal adverse consequences.

2 = Moderate Harm Inability to perform tasks within this element of practice would lead to error with moderate adverse consequences.

3 = Substantial Harm Inability to perform tasks within this element of practice would lead to error with substantial adverse consequences.

4 = Extreme Harm Inability to perform tasks within this element of practice would lead to error with extreme adverse consequences.

Veterinary clinical respondents view the elements of practice in a manner similar to veterinary anatomic pathologists, with Data Collection, Analysis, and Interpretation, Communication and Reports, and Quality Assurance being seen as having potential for substantial harm. The other elements of practice can be described as having potential for moderate harm. Table 51: Criticality of Clinical Elements of Practice


Mean1 SEM

Std. Dev.

I. Research and Investigative Design 123 1.86 0.10 1.07 II. Data Collection, Analysis, and Interpretation 120 2.92 0.08 0.89 III. Communication and Reports 116 2.91 0.09 0.93 IV. Quality Assurance 113 2.81 0.09 1.00 V. Public Health and Risk Management 112 2.26 0.12 1.27 VI. Education and Professional Development 109 2.07 0.10 1.08


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Figure 7: Mean Criticality by Clinical Element of Practice

1.86

2.92 2.912.81

2.26

2.07

0

1

2

3

4

EP I EP II EP III EP IV EP V EP VI

RA

TIN

G

Frequency of Elements of Practice The third key issue addressed by the scales is how often veterinary clinical pathologists work in the elements of practice. Respondents were asked to think of frequency in the following way: Frequency refers to the time that diplomates in veterinary clinical pathology [you] spend performing duties that require proficiency in each of the elements of practice, foundational sciences, or tasks. The following scale is used to record frequency for specific sciences and tasks: 0 = Never

Not responsible for this specific science or task.

1 = Rarely

About once per year.

2 = Sometimes

About once per month.

3 = Often

About once per week.

4 = Repetitively

About once or more per day.

The frequency evaluations of veterinary clinical pathology respondents for elements of practice are consistent with those for the veterinary anatomic pathology respondents. Veterinary clinical pathologists, on average, work most frequently in Communication and Reports, followed closely by Data Collection,

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Analysis, and Interpretation. They report that Public Health and Risk Management is the element of practice in which they work least often, but still between once per year and once per month. Table 52: Frequency of Clinical Elements of Practice


Mean1 SEM

Std. Dev.


1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Figure 8: Mean Frequency by Clinical Element of Practice

2.30

3.45

3.67

2.63

1.46

2.58

0

1

2

3

4

EP I EP II EP III EP IV EP V EP VI

RA

TIN

G

Tasks Within Clinical Elements of Practice The following pages present the list of task statements within each element of practice for veterinary clinical pathology, followed by tables of descriptive statistics that account for the data.

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Clinical Element of Practice I: Research and Investigative Design A. Gather technical and scientific information and expert opinions using appropriate sources in order to

generate a study designed to achieve optimal results. B. Contribute to the study design and application of appropriate clinical pathology endpoints and test

systems in cooperation with principal investigators in order to ensure optimal study results. C. Instruct clinicians, technical staff, and other professionals addressing the appropriate utilization and

collection of samples in order to ensure the highest quality of clinical pathology results. D. Recommend ancillary or follow-up testing for the principal investigator or clinician by integrating

previous results and/or other information in order to aid in the description, understanding, or diagnosis of a disease process.

E. Independently construct a hypothesis-driven investigation using the scientific method in order to

advance scientific knowledge. F. Develop investigational techniques and assays in clinical pathology using knowledge of materials and methods

in order to answer scientific questions and provide diagnoses. Table 53: Point of Acquisition for Tasks Within Clinical Element of Practice I (Research and Investigative Design)


0 20 15.3 1 77 58.8

Gather technical and scientific information to optimize study results 2 34 26.0

0 17 13.1 1 61 46.9

Contribute to the study design

2 52 40.0 0 6 4.6 1 99 76.2

Instruct clinicians, technical staff, and other professionals in assay selection and sample collection 2 25 19.2

0 7 5.5 1 90 70.3

Recommend ancillary or follow-up testing

2 31 24.2 0 21 16.3 1 62 48.1

Independently construct a hypothesis-driven investigation 2 46 35.7

0 17 13.2 1 45 34.9

Develop investigational techniques and assays in clinical pathology 2 67 51.9


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Table 54: Criticality of Tasks Within Clinical Element of Practice I (Research and Investigative Design)


Std. Dev.

Gather technical and scientific information to optimize study results 128 1.80 0.10 1.16

Contribute to the study design 128 2.02 0.10 1.13 Instruct clinicians, technical staff, and other professionals in assay selection and sample collection

129 2.46 0.10 1.08

Recommend ancillary or follow-up testing 128 2.13 0.09 1.05 Independently construct a hypothesis-driven investigation 127 1.55 0.10 1.09

Develop investigational techniques and assays in clinical pathology 127 1.65 0.09 1.06

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 55: Frequency of Tasks Within Clinical Element of Practice II (Research and Investigative Design)


Std. Dev.

Gather technical and scientific information to optimize study results 128 2.05 0.12 1.30

Contribute to the study design 128 2.09 0.11 1.23 Instruct clinicians, technical staff, and other professionals in assay selection and sample collection

128 2.89 0.10 1.10

Recommend ancillary or follow-up testing 128 2.95 0.10 1.11 Independently construct a hypothesis-driven investigation 127 1.61 0.10 1.16

Develop investigational techniques and assays in clinical pathology 127 1.62 0.10 1.15

1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Clinical Element of Practice II: Data Collection, Analysis, and Interpretation A. Understand the operating principles of current pathology instrumentation in order to appropriately

collect and analyze samples and to interpret the data. B. Collect samples using prescribed and other acceptable methods in order to support reliable pathology

analysis. C. Direct the collection of samples using acceptable and/or prescribed methods in order to support

reliable pathology analysis. D. Describe light and electron microscopic observations using a systematic approach and appropriate,

specific medical terminology in order to provide a complete and accurate record.

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E. Interpret light and electron microscopic observations using a systematic approach and appropriate,

specific medical terminology in order to characterize the pathogenesis of disease or formulate a diagnosis.

F. Describe hematological and hemostasis data using a systematic approach and appropriate, specific

medical terminology in order to provide a complete and accurate record. G. Interpret hematological and hemostasis data using a systematic approach and appropriate, specific

medical terminology in order to characterize the pathogenesis of disease or formulate a diagnosis. H. Describe clinical chemistry data using a systematic approach and appropriate, specific medical

terminology in order to provide a complete and accurate record. I. Interpret clinical chemistry data using a systematic approach and appropriate, specific medical

terminology in order to characterize the pathogenesis of disease or formulate a diagnosis. J. Describe data generated from the analysis of urine and other body fluids using a systematic approach and

appropriate, specific medical terminology in order to provide a complete and accurate record. K. Interpret data generated from the analysis of urine and other body fluids using a systematic approach and

appropriate, specific medical terminology in order to characterize the pathogenesis of disease or formulate a diagnosis.

L. Describe data generated from immunoassays using a systematic approach and appropriate, specific medical

terminology in order to provide a complete and accurate record. M. Interpret data generated from immunoassays using a systematic approach and appropriate, specific medical

terminology in order to characterize the pathogenesis of disease or formulate a diagnosis. N. Utilize molecular methods and novel testing techniques using a systematic approach and appropriate, specific

medical terminology in order to describe, interpret, and characterize the pathogenesis of disease or formulate a diagnosis.

O. Utilize immunocytochemistry, cytochemistry, and other specialized microscopic techniques using a systematic

approach and appropriate, specific medical terminology in order to describe, interpret, and characterize the pathogenesis of disease or formulate a diagnosis

P. Archive samples and/or related data using defined procedures in order to maintain a retrievable database for

quality assurance and legal purposes. Q. Apply proper statistical tests in accordance with the nature of the data in order to ensure the appropriate

interpretation of results. R. Provide a contextual interpretation by integrating clinical and non-clinical data in order to aid in the description,

understanding, and/or diagnosis of a disease process.

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Table 56: Point of Acquisition for Tasks Within Clinical Element of Practice II (Data Collection, Analysis, and Interpretation)

Tasks Within Element of Practice II: Point of Acquisition Scale Rating1 Count Percent

0 1 0.8 1 104 82.5

Understand the principles of current pathology instrumentation 2 21 16.7

0 18 14.3 1 97 77.0

Collect samples using appropriate methods

2 11 8.7 0 7 5.6 1 102 81.0

Direct the collection of samples

2 17 13.5 0 3 2.4 1 103 81.7

Describe light and electron microscopic observations 2 20 15.9

0 4 3.2 1 101 80.2

Interpret light and electron microscopic observations 2 21 16.7

0 0 0.0 1 107 84.9

Describe hematological and hemostasis data

2 19 15.1 0 1 0.8 1 105 83.3

Interpret hematological and hemostasis data

2 20 15.9 0 3 2.4 1 105 83.3

Describe clinical chemistry data

2 18 14.3 0 0 0.0 1 106 84.8

Interpret clinical chemistry data

2 19 15.2 0 3 2.4 1 105 84.7

Describe data generated from the analysis of urine and other body fluids 2 16 12.9

0 1 0.8 1 105 84.0

Interpret data generated from the analysis of urine and other body fluids 2 19 15.2

0 14 11.2 1 88 70.4

Describe data generated from immunoassays

2 23 18.4 0 11 8.8 1 90 72.0

Interpret data generated from immunoassays

2 24 19.2

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Table 56 (Continued): Point of Acquisition for Tasks Within Clinical Element of Practice II (Data Collection, Analysis, and Interpretation)


0 19 15.2 1 59 47.2

Utilize molecular methods and novel testing techniques 2 47 37.6

0 13 10.4 1 84 67.2

Utilize specialized microscopic techniques

2 28 22.4 0 22 17.6 1 53 42.4

Archive samples and/or related data

2 50 40.0 0 17 13.6 1 83 66.4

Apply proper statistical tests

2 25 20.0 0 4 3.2 1 93 74.4

Provide a contextual interpretation


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Table 57: Criticality of Tasks Within Clinical Element of Practice II (Data Collection, Analysis, and Interpretation)

Tasks Within Element of Practice II N Mean SEM

Std. Dev.

Understand the principles of current pathology instrumentation 126 2.37 0.09 1.04

Collect samples using appropriate methods 124 1.97 0.11 1.24 Direct the collection of samples 125 2.26 0.09 1.04 Describe light and electron microscopic observations 125 2.50 0.10 1.15

Interpret light and electron microscopic observations 125 2.84 0.09 1.05

Describe hematological and hemostasis data 126 2.73 0.08 0.94 Interpret hematological and hemostasis data 126 2.94 0.08 0.89 Describe clinical chemistry data 126 2.59 0.09 0.98 Interpret clinical chemistry data 125 2.82 0.08 0.90 Describe data generated from the analysis of urine and other body fluids 124 2.50 0.09 1.01

Interpret data generated from the analysis of urine and other body fluids 125 2.78 0.08 0.91

Describe data generated from immunoassays 123 2.17 0.10 1.08 Interpret data generated from immunoassays 123 2.45 0.09 1.00 Utilize molecular methods and novel testing techniques 123 1.84 0.11 1.20

Utilize specialized microscopic techniques 124 1.99 0.10 1.06 Archive samples and/or related data 121 1.90 0.12 1.27 Apply proper statistical tests 123 1.85 0.10 1.06 Provide a contextual interpretation 125 2.52 0.09 1.01


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Table 58: Frequency of Tasks Within Clinical Element of Practice II (Data Collection, Analysis, and Interpretation)


Std. Dev.

Understand the principles of current pathology instrumentation 126 3.13 0.08 0.92

Collect samples using appropriate methods 124 2.02 0.12 1.37 Direct the collection of samples 125 2.74 0.10 1.09 Describe light and electron microscopic observations 126 3.25 0.11 1.25

Interpret light and electron microscopic observations 126 3.29 0.11 1.18

Describe hematological and hemostasis data 126 3.48 0.08 0.86 Interpret hematological and hemostasis data 126 3.59 0.07 0.74 Describe clinical chemistry data 126 3.13 0.10 1.12 Interpret clinical chemistry data 125 3.27 0.09 0.95 Describe data generated from the analysis of urine and other body fluids 124 3.31 0.10 1.07

Interpret data generated from the analysis of urine and other body fluids 125 3.37 0.09 0.96

Describe data generated from immunoassays 124 2.10 0.11 1.24 Interpret data generated from immunoassays 124 2.27 0.11 1.23 Utilize molecular methods and novel testing techniques 124 1.52 0.10 1.11

Utilize specialized microscopic techniques 125 1.82 0.10 1.11 Archive samples and/or related data 122 2.35 0.14 1.51 Apply proper statistical tests 123 1.80 0.10 1.11 Provide a contextual interpretation 125 2.98 0.10 1.11

1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Clinical Element of Practice III: Communication and Reports A. Write clinical pathology reports using training, experience, professional judgment, and other

information in order to convey the interpretation in a clear, concise, and accurate manner. B. Author manuscripts using training, experience, and other information in order to disseminate

information and/or advance scientific knowledge. C. Deliver scientific or technical presentations using training, experience, and other information in

order to disseminate information and/or advance scientific knowledge. D. Communicate the significance of clinical pathology results using clear, concise oral and written

language in order to convey the potential implications for a subject, patient, or population (animal and/or human).

E. Respond to formal inquiries from regulatory agencies or other groups by utilizing pathology

expertise in order to address questions and concerns.

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F. Communicate clinical pathology knowledge to individuals with a variety of backgrounds (e.g., veterinarians, other professionals, technical staff, and lay people) using clear, concise oral and written language in order to facilitate their comprehension of the information.

Table 59: Point of Acquisition for Tasks Within Clinical Element of Practice III (Communication and Reporting)


0 0 0.0 1 100 82.0

Write clinical pathology reports

2 22 18.0 0 13 10.7 1 84 68.9 Author manuscripts 2 25 20.5 0 7 5.7 1 85 69.7

Deliver scientific or technical presentations

2 30 24.6 0 1 0.8 1 93 76.2

Communicate the significance of clinical pathology results 2 28 23.0

0 20 16.4 1 16 13.1

Respond to formal inquiries from regulatory agencies or other groups 2 86 70.5

0 0 0.0 1 83 68.0

Communicate clinical pathology knowledge

2 39 32.0 1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Table 60: Criticality of Tasks Within Clinical Element of Practice III (Communication and Reporting)


Std. Dev.

Write clinical pathology reports 122 2.84 0.10 1.05 Author manuscripts 122 1.61 0.10 1.07 Deliver scientific or technical presentations 122 1.67 0.09 1.02 Communicate the significance of clinical pathology results 121 2.72 0.10 1.06

Respond to formal inquiries from regulatory agencies or other groups 121 2.25 0.12 1.31

Communicate clinical pathology knowledge 122 2.34 0.09 0.99 1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm

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Table 61: Frequency of Tasks Within Clinical Element of Practice III (Communication and Reporting)


Std. Dev.

Write clinical pathology reports 122 3.70 0.07 0.77 Author manuscripts 122 1.78 0.09 0.98 Deliver scientific or technical presentations 122 1.99 0.09 0.98 Communicate the significance of clinical pathology results 121 3.26 0.09 1.03

Respond to formal inquiries from regulatory agencies or other groups 121 1.14 0.09 1.01

Communicate clinical pathology knowledge 122 2.97 0.09 1.00 1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Clinical Element of Practice IV: Quality Assurance A. Define standard operating procedures in accordance with prescribed methods in order to ensure

acceptable levels of quality and consistency. B. Evaluate specimens, reagents, instruments, and personnel training by inspection, review and

documentation in order to ensure the validity of data. C. Evaluate data for evidence of preanalytical and analytical error through inspection in order to

determine if verification and troubleshooting are required to obtain reliable results. D. Resolve quality assurance problems identified internally or externally through review and

evaluation using scientific knowledge and skills in order to maintain result reliability. E. Develop assays by designing, testing, and validating principles, materials, and methods in order

to create novel or improve current assays. F. Conduct reviews of reports and manuscripts by using scientific knowledge and professional

judgment in order to ensure the scientific rigor and/or usefulness of the information presented.

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Table 62: Point of Acquisition for Tasks Within Clinical Element of Practice IV (Quality Assurance)


0 15 12.6 1 51 42.9

Define standard operating procedures

2 53 44.5 0 10 8.4 1 47 39.5

Evaluate specimens, reagents, instruments, and personnel training to ensure validity of data 2 62 52.1

0 7 5.9 1 75 63.0

Evaluate data for evidence of preanalytical and analytical error 2 37 31.1

0 12 10.1 1 57 47.9

Resolve quality assurance problems

2 50 42.0 0 23 19.3 1 30 25.3

Develop and improve assays

2 66 55.5 0 11 9.2 1 42 35.3

Conduct reviews of reports and manuscripts

2 66 55.5 1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Table 63: Criticality of Tasks Within Clinical Element of Practice IV (Quality Assurance)


Std. Dev.

Define standard operating procedures 117 2.34 0.11 1.15 Evaluate specimens, reagents, instruments, and personnel training to ensure validity of data 118 2.46 0.10 1.12

Evaluate data for evidence of preanalytical and analytical error 118 2.49 0.10 1.06

Resolve quality assurance problems 117 2.39 0.11 1.14 Develop and improve assays 118 1.71 0.11 1.22 Conduct reviews of reports and manuscripts 119 1.90 0.10 1.10


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Table 64: Frequency of Tasks Within Clinical Element of Practice IV (Quality Assurance)


Std. Dev.

Define standard operating procedures 117 1.95 0.10 1.11 Evaluate specimens, reagents, instruments, and personnel training to ensure validity of data 118 2.12 0.11 1.18

Evaluate data for evidence of preanalytical and analytical error 118 2.53 0.11 1.17

Resolve quality assurance problems 117 2.09 0.11 1.16 Develop and improve assays 118 1.27 0.11 1.15 Conduct reviews of reports and manuscripts 119 1.92 0.10 1.11

1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Clinical Element of Practice V: Public Health and Risk Management A. Design appropriate sample handling protocols using training, experience, professional judgment, and

other information in order to minimize the exposure of personnel to infectious or toxic agents. B. Design standard protocols in compliance with federal and/or state regulations for hazardous

laboratory chemicals and biohazardous waste in order to minimize human and animal exposure and environmental contamination.

C. Recognize the public health significance of infectious agents by monitoring the incidence of disease

in order to inform appropriate regulatory agencies and/or potentially impacted individuals of the diagnosis.

D. Design clinical pathology testing strategies for disease surveillance using appropriate methods in

order to optimally manage animal populations. E. Integrate clinical pathology data collected from animals with the knowledge of comparative

pathology in order to identify the potential implications of natural and experimental disease for a subject, patient, or population (animal and/or human).

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Table 65: Point of Acquisition for Tasks Within Clinical Element of Practice V (Public Health and Risk Management)


0 22 19.0 1 36 31.0

Design safe sample handling protocols for infectious and toxic agents 2 58 50.0

0 33 28.4 1 21 18.1

Design protocols to manage chemicals and laboratory waste 2 62 53.4

0 34 29.3 1 42 36.2

Recognize the public health significance of infectious agents 2 40 34.5

0 46 39.7 1 18 15.5

Design clinical pathology testing strategies for disease surveillance 2 52 44.8

0 24 20.9 1 42 36.5

Integrate clinical and comparative pathology data to understand implications 2 49 42.6

1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Table 66: Criticality of Tasks Within Clinical Element of Practice V (Public Health and Risk Management)


Std. Dev.

Design safe sample handling protocols for infectiousad toxic agents 115 2.32 0.13 1.42

Design protocols to manage chemicals and laboratory waste 114 2.02 0.14 1.50

Recognize the public health significance of infectious agents 113 1.96 0.14 1.50

Design clinical pathology testing strategies for disease surveillance 114 1.43 0.13 1.36

Integrate clinical pathology and comparative pathology data to understand implications 114 1.99 0.12 1.29


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Table 67: Frequency of Tasks Within Clinical Element of Practice V (Public Health and Risk Management)


Std. Dev.

Design safe sample handling protocols for infectious and toxic agents 115 1.15 0.10 1.04

Design protocols to manage chemicals and laboratory waste 114 0.93 0.10 1.01

Recognize the public health significance of infectious agents 114 0.89 0.09 0.97

Design clinical pathology testing strategies for disease surveillance 115 0.52 0.07 0.77

Integrate clinical pathology and comparative pathology data to understand implications 114 1.36 0.12 1.28

1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Clinical Element of Practice VI: Education and Professional Development 1. Instruct veterinary students in the principles and applications of veterinary clinical pathology using

didactic, laboratory, practical, and/or group discussion in order to establish baseline knowledge and skills.

2. Instruct veterinary pathology residents through advanced training in veterinary clinical pathology

using didactic, laboratory, practical, and/or group discussion in order to facilitate proficiency in veterinary clinical pathology.

3. Provide continuing education and training in veterinary clinical pathology to practitioners, scientists,

technical staff, and other personnel using didactic, laboratory, practical, and/or group discussion in order to meet each group’s needs and goals.

4. Provide mentorship and guidance to trainees and colleagues by sharing professional experience and

knowledge in order to facilitate their professional development. 5. Participate in professional development activities by addressing identified interests and needs in order

to enhance proficiency as a veterinary clinical pathologist. 6. Provide education in aspects of veterinary clinical pathology to the general public using appropriate

channels in order to increase awareness of the profession. 7. Serve on professional and scientific committees by contributing professional knowledge and

experience in order to promote and improve the profession and benefit society.

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Table 68: Point of Acquisition for Tasks Within Clinical Element of Practice VI (Education and Professional Development)


0 19 17.0 1 67 59.8

Instruct veterinary students

2 26 23.2 0 17 15.2 1 32 28.6

Instruct veterinary pathology residents

2 63 56.3 0 11 9.7 1 43 38.1

Provide continuing education and training

2 59 52.2 0 5 4.5 1 32 28.6

Provide mentorship and guidance to trainees and colleagues 2 75 67.0

0 8 7.1 1 41 36.3

Participate in professional development activities

2 64 56.6 0 35 31.3 1 25 22.3

Provide education to the public in aspects of veterinary clinical pathology 2 52 46.3

0 13 11.6 1 15 13.4


2 84 75.0 1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Table 69: Criticality of Tasks Within Clinical Element of Practice VI (Education and Professional Development)


Std. Dev.

Instruct veterinary students 112 1.86 0.11 1.21 Instruct veterinary pathology residents 112 1.90 0.11 1.19 Provide continuing education and training 112 1.81 0.10 1.04 Provide mentorship and guidance to trainees and colleagues 112 1.61 0.09 0.97

Participate in professional development activities 113 1.47 0.09 0.96

Provide education to the public in aspects of veterinary clinical pathology 111 0.94 0.09 0.94

Serve on professional and scientific committees 112 1.15 0.08 0.87 1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm

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Table 70: Frequency of Tasks Within Clinical Element of Practice VI (Education and Professional Development)


Std. Dev.

Instruct veterinary students 112 1.97 0.15 1.57 Instruct veterinary pathology residents 112 2.10 0.15 1.54 Provide continuing education and training 112 1.81 0.10 1.04 Provide mentorship and guidance to trainees and colleagues 112 2.32 0.10 1.08

Participate in professional development activities 113 1.88 0.09 0.94

Provide education to the public in aspects of veterinary clinical pathology 111 0.77 0.08 0.84

Serve on professional and scientific committees 112 1.40 0.09 1.00 1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Clinical Foundational Sciences Table 71 reports the number of respondents selecting each option in the point of acquisition scale for foundational sciences. Not all respondents completed the entire survey, so the sum of counts may vary. It is apparent from the data presented in Table 71 that skill associated with all foundational sciences is expected when diplomates earn ACVP certification as veterinary clinical pathologists. Table 71: Point of Acquisition for Clinical Foundational Sciences

Frequency Analysis for Foundational Sciences: Acquisition Scale Rating1 Frequency Percent

0 5 4.4 1 101 89.4 Anatomy 2 7 6.2 0 11 9.9 1 81 73.0

Applied Mathematics and Statistics

2 19 17.1 0 4 3.6 1 98 88.3 Biology/Pathology 2 9 8.1 0 2 1.8 1 99 89.2 Chemistry 2 10 9.0 0 13 11.7 1 87 78.4 Microbiology 2 11 9.9 0 2 1.8 1 99 89.2

Physiology/ Pathophysiology

2 10 9.0 0 11 9.9 1 86 77.5 Physics 2 14 12.6


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Criticality Ratings for Foundational Sciences The criticality scale addresses the degree to which harmful consequences would occur if diplomates are not knowledgeable and skillful in the foundational sciences. Veterinary clinical pathologists indicate that the foundational science with the greatest criticality is Physiology/Pathophysiology (Substantial Harm). Biology/Pathology (Moderate Harm), Chemistry (Moderate Harm), and Anatomy (Moderate Harm) are the next most critical foundational sciences. Even the foundational science rated with the lowest criticality, Physics, would be characterized as associated with Moderate Harm. Table 72: Criticality of Clinical Foundational Sciences


Mean1 SEM

Std. Dev.

I. Anatomy 113 2.35 0.10 1.10 II. Applied Mathematics and Statistics 110 1.78 0.09 0.93 III. Biology/Pathology 111 2.49 0.10 1.09 IV. Chemistry 111 2.48 0.09 0.99 V. Microbiology 111 1.83 0.09 0.99 VI. Physiology/Pathophysiology 111 2.58 0.10 1.03 VII. Physics 111 1.72 0.10 1.00

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Figure 9: Mean Criticality by Clinical Foundational Science

2.35

1.78

2.49 2.48

1.83

2.58

1.72

0

1

2

3

4


RA

TIN

G

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Frequency of Foundational Sciences The third scale used in the validation study was Frequency, which accounts for how often veterinary pathologists draw on knowledge and skill in performing their work. Physiology/Pathophysiology are used with the greatest frequency, followed closely by Chemistry and Biology/Pathology. These three foundational sciences are applied to practice at least every week. The remaining foundational sciences are used at least monthly, if not weekly. Table 73: Frequency of Clinical Foundational Sciences

Performance Domain N

Mean1 SEM

Std. Dev.


1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Figure 10: Mean Frequency by Clinical Foundational Science

2.97

1.98

3.05 3.08

2.08

3.23

1.82

0

1

2

3

4

FS I FS II FS II FS IV FS V FS VI FS VII

RA

TIN

G

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Specific Sciences Within Clinical Foundational Sciences Veterinary clinical pathology respondents’ evaluation of the specific sciences within each foundational science used the Criticality scale. Descriptive statistics follow, organized in tables for each foundational science. Table 74: Criticality of Specific Sciences in Clinical Foundational Science I: Anatomy


Std. Dev.

Macroscopic Anatomy 115 1.73 0.11 1.19 Microscopic Anatomy 115 2.35 0.12 1.30 Histology 115 2.11 0.12 1.32 Cytology 115 2.97 0.11 1.13 Ultrastructural Anatomy 115 1.30 0.11 1.14

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 75: Criticality of Specific Sciences in Clinical Foundational Science II: Applied Mathematics and Statistics


Std. Dev.

Data Management Systems 113 1.48 0.11 1.13 Biostatistics 113 1.66 0.10 1.04 Bioinformatics 113 1.27 0.09 0.98

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 76: Criticality of Specific Sciences in Clinical Foundational Science III: Biology/Pathobiology


Std. Dev.

Cell Biology 113 1.93 0.10 1.11 Developmental Biology and Aging 113 1.33 0.09 0.96 Genetics 113 1.36 0.09 0.95 Immunology 113 2.15 0.10 1.08 Molecular Biology 113 1.86 0.10 1.03 Cancer Biology 112 2.11 0.10 1.07


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Table 77: Criticality of Specific Sciences in Clinical Foundational Science IV: Chemistry


Std. Dev.

Biochemistry 113 2.10 0.10 1.09 Clinical Chemistry 113 2.92 0.10 1.04

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 78: Criticality of Specific Sciences in Clinical Foundational Science V: Microbiology


Std. Dev.

Mycology 112 1.70 0.10 1.08 Virology 113 1.73 0.10 1.10 Parasitology 113 1.84 0.09 1.00 Bacteriology 113 1.98 0.10 1.09

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 79: Criticality of Specific Sciences in Clinical Foundational Science VI: Physiology/ Pathophysiology


Std. Dev.

Biotransformation 112 1.29 0.10 1.02 Endocrinology 112 2.53 0.09 1.00 Hematology 112 3.06 0.09 0.97 Metabolism 112 2.00 0.10 1.10 Reproduction 112 1.42 0.08 0.86 Pharmacology 112 1.63 0.10 1.09 Nutrition 112 1.20 0.08 0.84 Toxicology 112 2.18 0.11 1.15

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 80: Criticality of Specific Sciences in Clinical Foundational Science VII: Physics

Specific Science N Mean1 SEM

Std. Dev.

Instrumentation 112 2.02 0.10 1.06 1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Clinical Tools Veterinary pathologists employ tools in their practice. Knowing which tools are used on a routine basis by veterinary clinical pathologists provides insight that ACVP may use in different ways. Following are tables for tools evaluation for veterinary clinical pathology respondents.

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Table 81: Point of Acquisition for Clinical Tools Frequency Analysis for Tools: Acquisition Scale

Rating1 Count Percent Histology/Cytology

0 11 9.2 1 98 81.7

Light Microscopy Standard HE

2 11 9.2 0 2 1.7 1 105 87.5


2 13 10.8 0 14 11.7 1 88 73.3


0 15 12.5 1 83 69.2


2 22 18.3 0 53 44.2 1 33 27.5 In Situ Hybridization 2 34 28.3 0 21 17.5 1 78 65.0 Photomicroscopy 2 21 17.5

Clinical Pathology 0 0 0.0 1 105 87.5 Clinical Chemistry

Interpretation 2 15 12.5 0 1 0.8 1 104 86.7


2 15 12.5 0 1 0.8 1 103 85.8


2 16 13.3 0 8 6.7 1 82 68.3


2 30 25.0 0 6 5.0 1 85 70.8


2 29 24.2 0 11 9.2 1 78 65.0 Coagulation

Analyzers 2 31 25.8


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Table 81 (Continued): Point of Acquisition for Clinical Tools Frequency Analysis for Tools: Acquisition Scale

Rating1 Frequency Percent 0 19 15.8 1 73 60.8 Blood Gas Analyzers 2 28 23.3 0 23 19.2 1 59 49.2



0 45 37.5 1 37 30.8


2 38 31.7 0 47 39.2 1 54 45.0


2 19 15.8 0 68 56.7 1 21 17.5


2 31 25.8 0 57 47.5 1 42 35.0


2 21 17.5 0 61 50.8 1 20 16.7 Confocal Microscopy 2 39 32.5 0 55 45.8 1 21 17.5


2 44 36.7 0 72 60.0 1 12 10.0

Intravital Microscopy

2 36 30.0 Other Investigational Techniques/Tools

0 77 64.7 1 17 14.3


0 63 52.9 1 19 16.0


2 37 31.1 0 77 64.7 1 12 10.1



90




Rating1 Frequency Percent 0 19 16.0 1 65 54.6 Flow Cytometry 2 35 29.4 0 70 58.8 1 12 10.1


2 37 31.1 0 36 30.3 1 56 47.1 Spectrophotometry 2 27 22.7 0 57 47.9 1 29 24.4 Cell Culture 2 33 27.7 0 47 39.5 1 16 13.4 Telepathology 2 56 47.1 0 73 61.3 1 10 8.4


2 36 30.3 Biochemical and Molecular Techniques/ Tools

0 32 26.9 1 56 47.1


2 31 26.1 0 65 54.6 1 20 16.8 Gene Microarray 2 34 28.6 0 69 58.0 1 19 16.0 Protein Microarray 2 31 26.1 0 69 58.0 1 15 12.6 Tissue Microarray 2 35 29.4 0 72 60.5 1 17 14.3


2 30 25.2 0 44 37.0 1 41 34.5



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Rating1 Frequency Percent 0 71 59.7 1 17 14.3 FISH/Cytogenetics 2 31 26.1 0 18 15.1 1 71 59.7



1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Table 82: Criticality of Clinical Tools

Tools N Mean1 SEM

Std. Dev.

Histology/Cytology Light Microscopy Standard HE 120 2.4 0.1 1.3 Cytology (standard Wright-Giemsa) 120 2.9 0.1 1.1 Histochemistry/Cytochemistry(Special Stains) 120 1.8 0.1 1.1 Immunohistochemistry/Immunocytochemistry 120 1.9 0.1 1.2 In Situ Hybridization 120 0.9 0.1 1.1 Photomicroscopy 120 1.1 0.1 1.0 Clinical Pathology Clinical Chemistry Interpretation 120 3.0 0.1 0.9 Hematology Interpretation 120 3.0 0.1 1.0 Urinalysis Interpretation 120 2.7 0.1 1.1 Clinical Chemistry Analyzers 120 2.1 0.1 1.1 Hematology Analyzers 120 2.1 0.1 1.1 Coagulation Analyzers 120 1.9 0.1 1.1 Immunoassay Analyzers 120 1.6 0.1 1.1


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Table 82(Continued): Criticality of Clinical Tools

Tools

N

Mean1

SEM

Std. Dev.

Special Microscopy Techniques Fluorescence Microscopy 119 0.9 0.1 1.0 Transmission Electron Microscopy 119 0.9 0.1 1.0 Immunoelectron Microscopy 119 0.5 0.1 0.7 Scanning Electron Microscopy 119 0.6 0.1 0.8 Confocal Microscopy 119 0.5 0.1 0.7 Computer-Aided Slide Analysis 119 0.7 0.1 0.9 Intravital Microscopy 118 0.4 0.1 0.7 Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) 118 0.5 0.1 0.9



PCR and Related Molecular Techniques 118 1.4 0.1 1.2 Gene Microarray 118 0.6 0.1 0.9 Protein Microarray 118 0.5 0.1 0.8 Tissue Microarray 118 0.6 0.1 0.8 Gene Regulation/Mutagenesis 118 0.5 0.1 0.9 Western Blotting and Related Proteomic Techniques 118 0.9 0.1 1.0




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Table 83: Frequency of Clinical Tools

Tools N Mean1 SEM

Std. Dev.

Histology/Cytology Light Microscopy Standard HE 120 2.6 0.1 1.4 Cytology (standard Wright-Giemsa) 120 3.4 0.1 1.1 Histochemistry/Cytochemistry(Special Stains) 120 1.8 0.1 1.2 Immunohistochemistry/Immunocytochemistry 120 1.8 0.1 1.2 In Situ Hybridization 120 0.5 0.1 0.8 Photomicroscopy 120 2.0 0.1 1.2 Clinical Pathology Clinical Chemistry Interpretation 120 3.5 0.1 0.8 Hematology Interpretation 120 3.7 0.1 0.7 Urinalysis Interpretation 120 3.4 0.1 0.9 Clinical Chemistry Analyzers 120 2.3 0.1 1.2 Hematology Analyzers 120 2.5 0.1 1.2 Coagulation Analyzers 120 1.9 0.1 1.3 Blood Gas Analyzers 120 1.5 0.1 1.2 Immunoassay Analyzers 120 1.4 0.1 1.3 Special Microscopy Techniques Fluorescence Microscopy 119 0.6 0.1 0.8 Transmission Electron Microscopy 119 0.6 0.1 0.8 Immunoelectron Microscopy 119 0.1 0.1 0.4 Scanning Electron Microscopy 119 0.3 0.1 0.6 Confocal Microscopy 119 0.4 0.1 0.7 Computer-Aided Slide Analysis 119 0.4 0.1 0.8 Intravital Microscopy 119 0.2 0.1 0.6 Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) 118 0.4 0.1 0.8





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Tools N Mean1 SEM

Std. Dev.

Western Blotting and Related Proteomic Techniques 118 0.8 0.1 0.9




Reliability Analysis The reliability of the scales for elements of practice was assessed in order to determine how consistently the tasks measured the element of practice of interest. Reliability refers to the degree to which tests or surveys are free from measurement error. With inconsistency (i.e., unreliability), it would be impossible to interpret the results of the study. Reliability analysis expresses the accuracy of data reported for the Point of Acquisition, Criticality, and Frequency ratings of each element of practice and foundational science, both for veterinary anatomic pathologists and veterinary clinical pathologists. Reliability was measured by estimating internal consistency (Cronbach’s Alpha) using the respondent’s ratings for Point of Acquisition, Criticality, and Frequency for each element of practice and foundational science. This procedure calculates the extent to which each task rating within an element of practice or specific science rating within the foundational sciences consistently measures what other tasks within that element of practice or specific sciences with that foundational science measure. Reliability coefficients range from 0 to 1 and should be above .7 to be judged as adequate. Reliability values below .7 indicate relative inconsistency. Only one reliability coefficient was below the .7 threshold, Communication and Reporting for the veterinary anatomic pathology specialty. That said, the coefficient (.66) approached the .7 threshold, so this slight divergence from statistical acceptability is judged not to invalidate the reliability of the results obtained for this element of practice.

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Table 84: Reliability Estimates — Anatomic Elements of Practice

RELIABILITY

Element of Practice

N

# of Task

s

Acquisition

Criticality

Frequency

I. Research and Investigative Design 697 4 .82 .89 .86

II. Data Collection 674 10 .85 .91 .88 III. Data Analysis and

Interpretation 651 9 .78 .87 .76

IV. Communication and Reporting 643 6 .66 .79 .74

V. Quality Assurance 636 7 .85 .89 .83 VI. Public Health and Risk

Management 625 8 .88 .90 .76

VII. Education and Professional Development 608 9 .83 .90 .84

Table 85: Reliability Estimates — Anatomic Foundational Sciences

RELIABILITY Foundational Science

Sample Size(n) # of Specific Sciences Criticality

I. Anatomy and Physiology 619 7 .84 II. Biology 615 5 .84 III. Physical Sciences 612 4 .87 IV. Applied Mathematics and

Statistics 614 3 .75

V. Medicine 614 4 .76 VI. Pathology 613 4 .84 VII. Microbiology and Infectious

Disease 610 4 .95

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Table 86: Reliability Estimates — Clinical Elements of Practice RELIABILITY

Element of Practice N # of

Tasks Acquisitio

n Criticality Frequency


II. Data Collection, Data Analysis, and Interpretation 124 18 .90 .94 .88

III. Communication and Reporting 122 6 .73 .82 .59

IV. Quality Assurance 119 6 .82 .90 .85 V. Public Health and Risk

Management 115 5 .86 .82 .81

VI. Education and Professional Development 111 7 .82 .89 .84

Table 87: Reliability Estimates — Clinical Foundational Sciences



I. Anatomy 115 5 .85 II. Applied Mathematics and


III. Biology/Pathology 112 6 .92 IV. Chemistry 113 2 .78 V. Microbiology 112 4 .94 VI. Physiology/Pathophysiology 112 8 .87 VII. Physics --- 1 ---

Conclusion

The ACVP conducted the role delineation study to describe the proficient practice of veterinary anatomic pathology and veterinary clinical pathology diplomates as the means for establishing the content validity of its certifying examinations in these specialties and for defining a logical basis for organizing its training and continuing education programs. All practicing diplomates of the College were asked to participate in the validation survey component of the project, and 57.7% of veterinary anatomic pathologists and 49.9% of veterinary clinical pathologists provided useful data. Responses to items in the demographic portion of the survey support the conclusion that participants constituted a reasonable sample of diplomates across a variety of practice settings. Elements of practice, tasks, foundational sciences, and tools were validated using scales for point of acquisition, criticality, and frequency. Specific sciences were validated for criticality. The point of acquisition scale provided a clear demarcation of what is expected for new diplomates and thus provides important guidance for the content for the certification examinations. The point of acquisition scales also permits the clear identification of factors associated with more advanced aspects of practice. Criticality (potential for harm) and frequency (how often) supplied support for decision making about the role

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delineation, which may be used to define guidelines for appropriate examination content as well as improving training programs of the ACVP. In developing the plan for the examination program, the ACVP established threshold values for mean ratings for acquisition, criticality, and frequency for the purpose of specifying appropriate content for the certifying examinations and training programs. Elements of practice, tasks, foundational sciences, specific sciences, and tools were examined relative to the recommended thresholds using data from all respondents. The appendix includes an analysis based only on respondents who achieved certification in the years 2003 through 2007 (i.e., recently certified diplomates), and this analysis was used as a basis of comparison to validate the appropriateness of the delineation for the certification examinations. This analysis produced results that are quite similar to that based on all respondents. An additional analysis that compares the responses from veterinary pathologists working in different settings was also performed and will be presented separately from this report. This analysis is recommended as the basis for ACVP’s continuing education programs.

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Appendix A: Analysis of Data for New Diplomates (2003 – 2007)

Demographics for New Diplomates (2003-2007) Table 1: Degrees Earned *

Anatomic Clinical Degree

Frequency Percent Frequency Percent DVM/VMD (or equivalent) 165 98.8 43 100.0 PhD 72 43.1 7 16.3 MBA 1 0.6 0 0.0 MPH 2 1.2 0 0.0 Other Master’s 38 22.8 14 32.6 Other General 15 9.0 6 14.0

* NOTE: Respondents could select more than one degree, so it is not reasonable to add the frequency or percent information. Table 2: Year ACVP Certification Earned

Anatomic Clinical Year Frequency Percent Frequency Percent

2003 26 15.6 4 9.3 2004 42 25.1 14 32.6 2005 19 11.4 6 14.0 2006 36 21.6 8 18.6 2007 44 26.3 11 25.6 Total 167 100.0 43 100.0

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Table 3: Other Certifications Earned* Anatomic Clinical

Certification Frequency Percent Frequency Percent

ABVP 2 1.2 0 0.0 ABVT 0 0.0 0 0.0 ACLAM 1 0.6 0 0.0 ACPV 0 0.0 0 0.0 ACTHERIO 0 0.0 0 0.0 ACVA 0 0.0 0 0.0 ACVB 0 0.0 0 0.0 ACVCP 0 0.0 0 0.0 ACVD 0 0.0 0 0.0 ACVECC 0 0.0 0 0.0 ACVIM 0 0.0 1 2.3 ACVM 1 0.6 0 0.0 ACVN 0 0.0 0 0.0 ACVO 0 0.0 0 0.0 ACVPM 0 0.0 0 0.0 ACVR 0 0.0 0 0.0 ACVS 0 0.0 0 0.0 ACZM 0 0.0 0 0.0 AVDC 0 0.0 0 0.0 ABTOX 1 0.6 0 0.0 ECVP 1 0.6 0 0.0 ECVCP 0 0.0 0 0.0 One Certification Not Listed 7 4.2 2 4.7 Two Certifications Not Listed 0 0.0 0 0.0

* NOTE: Respondents could select more than one certification, so it is not reasonable to add the frequency or percent information.

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Table 4: Mean Frequency Estimates for Species Anatomic Clinical

Species N

Mean

Standard Deviation

N

Mean

Standard Deviation

Birds 157 1.1 1.2 41 2.0 1.1 Cats 152 1.5 1.7 41 3.6 1.0 Cows 152 1.3 1.6 40 2.0 1.2 Dogs 160 2.5 1.4 42 3.8 0.8 Fish 153 0.6 0.7 40 0.7 0.7 Horses 153 1.3 1.5 41 2.9 1.2 Marine Mammals 151 0.4 0.8 40 0.8 0.7 Non-Human Primates 158 1.6 1.3 42 1.1 1.2 Pigs 154 1.2 1.1 42 0.9 0.8 Pocket Pets 148 0.8 1.0 40 1.5 1.0 Poultry 152 0.6 0.9 40 0.6 0.8 Rabbits 157 1.3 0.8 41 1.5 0.8 Reptiles and Amphibians 153 0.8 0.9 40 1.5 0.9 Rodents 164 2.7 1.3 42 1.8 1.1 Small Ruminants 155 1.2 1.4 40 1.6 1.0 Wildlife 155 1.0 1.3 40 1.2 1.0 Zoo Animals 151 0.8 1.1 40 1.3 1.0

Table 5: Descriptive Statistics for Percentage of Work Week in Practice Areas

Anatomic Clinical Practice Settings

N

Mean Std Dev

N

Mean

Std Dev

Academic 87 68.3 41.4 28 64.4 42.8 Teaching 68 17.7 14.8 22 26.9 15.6 Research 66 38.7 32.1 21 22.0 24.3 Clinical 49 27.7 19.8 18 35.3 18.6 Administration 40 12.5 13.4 12 9.4 14.9 Diagnostic 41 61.0 39.4 24 75.4 35.2 Government 25 55.7 44.6 1 0.0 0.0 Industry 68 89.0 28.9 7 75.6 42.3 Chemical 4 31.3 46.6 1 0.0 0.0 Pharmaceutical 34 85.2 24.5 4 72.5 48.6 Biotechnology 8 45.0 25.6 2 5.0 7.1 Contract 26 87.7 30.0 4 57.3 50.3 Medical Devices 6 57.7 46.2 1 0.0 0.0 Research 14 35.4 40.9 4 26.8 48.9 Private Practice 5 20.0 44.7 1 0.0 0.0 Non-practicing 4 0.0 0.0 1 0.0 0.0 Other 7 23.6 28.1 2 26.5 33.2


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Table 6: Administrative and/or Management Role Anatomic Clinical Response

Frequency Percent Frequency Percent Yes 63 37.7 15 34.9 No 104 62.3 28 65.1 Total 167 100.0 43 100.0

Table 7: Percent of Time Spent in an Administrative and/or Management Role

Anatomic Clinical N Mean Std Dev N Mean Std Dev

Time Spent 61 20.3 18.2 15 22.3 18.4 Table 8: Respondents Involved in Training Veterinary Pathologists for Board Eligibility


Yes 67 40.9 22 51.2 No 97 59.1 21 48.8 Total 164 100.0 43 100.0

Table 9: Percent of Time Spent in Training Veterinary Pathologists for Board Eligibility


Time Spent 66 15.1 14.7 22 22.5 20.4 Table 10: Full and Part Time Work Status


Full time 154 96.3 40 95.2 Part time 5 3.1 2 4.8 Retired 1 0.6 Total 160 100.0 42 100.0

Table 11: Percent of Time Spent Practicing Veterinary Pathology


Time Spent 166 78.7 28.0 43 83.2 24.9

102



Table 12: Primary State, Province, or International Region Anatomic Clinical Location


Alaska 0 0.0 0 0.0 Arkansas 0 0.0 0 0.0 Alabama 3 1.8 1 2.3 Arizona 1 0.6 0 0.0 California 14 8.4 1 2.3 Colorado 1 0.6 2 4.7 Connecticut 3 1.8 0 0.0 District of Columbia 3 1.8 0 0.0 Delaware 0 0.0 0 0.0 Florida 4 2.4 0 0.0 Georgia 2 1.2 0 0.0 Hawaii 1 0.6 0 0.0 Iowa 5 3.0 0 0.0 Illinois 1 0.6 1 2.3 Indiana 13 7.8 0 0.0 Kansas 2 1.2 0 0.0 Kentucky 1 0.6 0 0.0 Louisiana 2 1.2 0 0.0 Massachusetts 12 7.2 2 4.7 Maryland 11 6.6 1 2.3 Maine 1 0.6 0 0.0 Michigan 7 4.2 2 4.7 Minnesota 3 1.8 1 2.3 Missouri 4 2.4 2 4.7 Mississippi 0 0.0 1 2.3 Montana 0 0.0 0 0.0 North Carolina 10 6.0 1 2.3 Nebraska 0 0.0 0 0.0 New Hampshire 0 0.0 0 0.0 New Jersey 5 3.0 1 2.3 New Mexico 0 0.0 0 0.0 Nevada 0 0.0 0 0.0 New York 3 1.8 1 2.3 Ohio 6 3.6 1 2.3 Oklahoma 2 1.2 3 7.0 Oregon 0 0.0 1 2.3 Pennsylvania 5 3.0 3 7.0 South Carolina 0 0.0 1 2.3 South Dakota 0 0.0 0 0.0 Tennessee 2 1.2 1 2.3 Texas 2 1.2 2 4.7 Utah 1 0.6 0 0.0 Virginia 4 2.4 0 0.0 Washington 5 3.0 2 4.7

103



Table 12 (Continued): Primary State, Province, or International Region Anatomic Clinical Location


Wisconsin 7 4.2 1 2.3 West Virginia 0 0.0 0 0.0 Wyoming 0 0.0 0 0.0

Canada Alberta 1 0.6 1 2.3 British Columbia 0 0.0 1 2.3 Nova Scotia 0 0.0 0 0.0 Ontario 0 0.0 1 2.3 Prince Edward Island 1 0.6 1 2.3 Quebec 6 3.6 0 0.0 Saskatchewan 2 1.2 1 2.3

International Regions Africa 0 0.0 0 0.0 Asia/Pacific Islands 1 0.6 2 4.7 Australia 4 2.4 2 4.7 Europe 5 3.0 2 4.7 No Response 1 0.6 0 0.0 Total 167 100.0 43 100.0

Table 13: Gender


Male 72 43.1 10 23.3 Female 94 56.3 33 76.7 No Response 1 0.6 0 0.0 Total 167 100.0 43 100.0

104



Validation of Veterinary Anatomic Pathologists’ Roles Anatomic Elements of Practice Table 14: Point of Acquisition for Anatomic Elements of Practice

Element of Practice Rating1 Count Percent 0 20 12.9 1 78 50.3


0 5 3.4 1 130 87.8 II. Data Collection 2 13 8.8 0 5 3.5 1 118 83.7

III. Data Analysis and Interpretation

2 18 12.8 0 5 3.6 1 104 75.9

IV. Communication and Reporting

2 28 20.4 0 10 7.3 1 45 32.8 V. Quality Assurance 2 82 59.9 0 21 15.4 1 48 35.3

VI. Public Health and Risk Management

2 67 49.3 0 7 5.1 1 62 45.3

VII. Education and Professional Development 2 68 49.6

1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Table 15: Criticality of Anatomic Elements of Practice


Mean1 SEM

Std. Dev.



105



Table 16: Frequency of Anatomic Elements of Practice


Mean

1 SEM Std. Dev.


1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Evaluation of Tasks Within Anatomic Elements of Practice Table 17: Point of Acquisition for Tasks Within Anatomic Element of Practice I (Research and Investigative Design)


0 25 15.2 1 88 53.7

Design experiments and diagnostic investigations

2 51 31.1 0 17 10.4 1 58 35.4

Coordinate research and diagnostic investigations

2 89 54.3 0 18 11.0 1 83 50.6

Develop investigational techniques

2 63 38.4 0 22 13.4 1 62 37.8

Use animal models of disease

2 80 48.8 1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Table 18: Criticality of Tasks Within Anatomic Element of Practice I (Research and Investigative Design)


Std. Dev.

Design experiments and diagnostic investigations 162 2.0 0.1 1.2 Coordinate research and diagnostic investigations 161 2.2 0.1 1.2 Develop investigational techniques 162 1.9 0.1 1.1 Use animal models of disease 162 2.1 0.1 1.3


106



Table 19: Frequency of Tasks Within Anatomic Element of Practice I (Research and Investigative Design)


Std. Dev.

Design experiments and diagnostic investigations 162 2.2 0.1 1.3 Coordinate research and diagnostic investigations 161 2.3 0.1 1.3 Develop investigational techniques 162 2.1 0.1 1.2 Use animal models of disease 162 2.0 0.1 1.5

1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Table 20: Point of Acquisition for Tasks Within Anatomic Element of Practice II (Data Collection)


0 10 6.3 1 134 84.8

Review antemortem data and history to collect relevant samples 2 14 8.9

0 9 5.7 1 128 81.0

Guide sample collection by others

2 21 13.3 0 7 4.4 1 137 86.7 Perform necropsies 2 14 8.9 0 14 8.9 1 126 79.7

Collect gross morphometric data

2 18 11.4 0 7 4.4 1 136 86.1

Collect specimens to preserve sample integrity

2 15 9.5 0 5 3.1 1 136 85.5

Describe morphological observations

2 18 11.3 0 5 3.1 1 123 77.4

Photograph gross and microscopic observations

2 31 19.5 0 2 1.3 1 128 81.0 Select applicable assays 2 28 17.7 0 36 22.6 1 48 30.2

Perform microscopic, morphometric, analyses, quantitative interpretations 2 75 47.2

0 6 3.8 1 120 75.5

Perform critical reviews of literature and data


107



Table 21: Criticality of Tasks Within Anatomic Element of Practice II (Data Collection)


Std. Dev.


Guide sample collection by others 157 2.5 0.1 1.1 Perform necropsies 157 2.7 0.1 1.1 Collect gross morphometric data 157 2.0 0.1 1.1 Collect specimens to preserve sample integrity 157 2.5 0.1 1.1 Describe morphological observations 158 2.8 0.1 1.1 Photograph gross and microscopic observations 158 1.6 0.1 0.9 Select applicable assays 158 2.3 0.1 1.0 Perform microscopic, morphometric analyses, quantitative interpretations 156 1.2 0.1 1.0 Perform critical reviews of literature and data 158 2.0 0.1 1.0

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 22: Frequency of Tasks Within Anatomic Element of Practice II (Data Collection)


Std. Dev.


Guide sample collection by others 157 2.8 0.1 1.2 Perform necropsies 157 2.8 0.1 1.3 Collect gross morphometric data 156 2.4 0.1 1.4 Collect specimens to preserve sample integrity 157 2.7 0.1 1.3 Describe morphological observations 158 3.4 0.1 1.0 Photograph gross and microscopic observations 158 2.5 0.1 1.1 Select applicable assays 158 2.8 0.1 1.1 Perform microscopic, morphometric analyses, quantitative interpretations 156 1.2 0.1 1.1 Perform critical reviews of literature and data 158 2.5 0.1 1.1


108



Table 23: Point of Acquisition for Tasks Within Anatomic Element of Practice III (Data Analysis and Interpretation)


0 5 3.2 1 134 87.0

Evaluate tissue morphology

2 15 9.7 0 15 9.9 1 91 59.9

Use special microscopic techniques

2 46 30.3 0 2 1.3 1 127 83.0

Interpret immunohistochem-istry, histochemistry, in situ immunochemistry and hybridization 2 24 15.7

0 23 15.2 1 63 41.7

Interpret advanced tissue-based cellular and molecular biology data 2 65 43.0

0 29 19.1 1 66 43.4

Integrate pathologic and epidemiological findings

2 57 37.5 0 6 3.9 1 117 76.5

Integrate individual animal data

2 30 19.6 0 3 2.0 1 117 76.5

Interpret normal variations and spontaneous findings 2 33 21.6

0 3 2.0 1 130 85.0

Identify artifacts in tissue sections and other samples 2 20 13.1

0 15 9.8 1 51 33.3

Organize complete data sets for study analysis


109



Table 24: Criticality of Tasks Within Anatomic Element of Practice III (Data Analysis and Interpretation)


Std. Dev.

Evaluate tissue morphology 152 3.1 0.1 1.0 Use special microscopic techniques 151 2.1 0.1 1.2 Interpret immunohistochemistry, histochem-istry, in situ immunochemistry and hybridization 152 2.3 0.1 1.0 Interpret advanced tissue-based cellular and molecular biology data 150 1.7 0.1 1.1 Integrate pathologic and epidemiological findings 151 1.9 0.1 1.3 Integrate individual animal data 152 2.5 0.1 1.1 Interpret normal variations and spontaneous findings 152 2.6 0.1 1.0 Identify artifacts in tissue sections and other samples 152 2.6 0.1 1.0 Organize complete data sets for study analysis 151 2.0 0.1 1.1

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 25: Frequency of Tasks Within Anatomic Element of Practice III (Data Analysis and Interpretation)


Std. Dev.

Evaluate tissue morphology 152 3.6 0.1 0.7 Use special microscopic techniques 151 2.2 0.1 1.3 Interpret immunohistochemistry, histochem-istry, in situ immunochemistry and hybridization 152 2.4 0.1 1.1 Interpret advanced tissue-based cellular and molecular biology data 150 1.6 0.1 1.2 Integrate pathologic and epidemiological findings 151 1.3 0.1 1.2 Integrate individual animal data 151 2.9 0.1 1.1 Interpret normal variations and spontaneous findings 152 3.2 0.1 0.9 Identify artifacts in tissue sections and other samples 152 3.3 0.1 0.8 Organize complete data sets for study analysis 151 2.2 0.1 1.3


110



Table 26: Point of Acquisition for Tasks Within Anatomic Element of Practice IV (Communication and Reporting)


0 3 2.0 1 115 77.7

Communicate pathology findings and their significance to clinicians, regulators, and scientists 2 30 20.3

0 38 25.9 1 42 28.6

Communicate animal disease to the public.

2 67 45.6 0 34 23.0 1 27 18.2

Discuss scientific findings in public forums to educate stakeholders 2 87 58.8

0 9 6.1 1 99 66.9

Publish scientific findings in peer reviewed literature 2 40 27.0

0 10 6.8 1 96 64.9

Disseminate knowledge thru publications, abstracts, reports, and presentations 2 42 28.4

0 40 27.0 1 11 7.4

Testify as an expert witness or as the pathologist of record 2 97 65.5

1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Table 27: Criticality of Tasks Within Anatomic Element of Practice IV (Communication and Reporting)


Std. Dev.

Communicate pathology findings and their significance to clinicians, regulators, and scientists 147 3.0 0.1 1.0 Communicate animal disease to the public 146 2.1 0.1 1.5 Discuss scientific findings in public forums to educate stakeholders 146 2.0 0.1 1.4 Publish scientific findings in peer reviewed literature. 147 1.9 0.1 1.1 Disseminate knowledge through publications, abstracts, reports, and presentations 147 1.8 0.1 1.0 Testify as an expert witness or as the pathologist of record 145 2.0 0.1 1.5


111



Table 28: Frequency of Tasks Within Anatomic Element of Practice IV (Communication and Reporting)


Std. Dev.

Communicate pathology findings and their significance to clinicians, regulators, and scientists 146 3.5 0.1 0.8 Communicate animal disease to the public 145 1.0 0.1 1.1 Discuss scientific findings in public forums to educate stakeholders 144 1.1 0.1 1.0 Publish scientific findings in peer reviewed literature. 147 1.6 0.1 0.9 Disseminate knowledge through publications, abstracts, reports, and presentations 147 1.6 0.1 0.8 Testify as an expert witness or as the pathologist of record 145 0.5 0.1 0.8

1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Table 29: Point of Acquisition for Tasks Within Anatomic Element of Practice V (Quality Assurance)


0 18 12.5 1 39 27.1


0 14 9.7 1 24 16.6 Supervise technical staff 2 107 73.8 0 25 17.2 1 15 10.3

Conduct pathology peer review

2 105 72.4 0 38 26.2 1 17 11.7

Resolve discrepancies using pathology working groups and external experts 2 90 62.1

0 20 13.8 1 36 24.8

Provide results in accordance with SOPs or scientific principles 2 89 61.4

0 31 21.4 1 18 12.4

Author standard operating procedures

2 96 66.2 0 50 34.7 1 8 5.6

Conduct laboratory inspections


112



Table 30: Criticality of Tasks Within Anatomic Element of Practice V (Quality Assurance)


Std. Dev.

Conduct reviews of designs, proposals, results, and manuscripts 142 2.0 0.1 1.1 Supervise technical staff 143 2.1 0.1 1.1 Conduct pathology peer review 142 1.9 0.1 1.2 Resolve discrepancies using pathology working groups and external experts 142 1.6 0.1 1.3 Provide results in accordance with SOPs or scientific principles 142 2.1 0.1 1.1 Author standard operating procedures 143 1.7 0.1 1.2 Conduct laboratory inspections 141 1.4 0.1 1.3

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 31: Frequency of Tasks Within Anatomic Element of Practice V (Quality Assurance)


Std. Dev.

Conduct reviews of designs, proposals, results, and manuscripts 142 1.7 0.1 1.1 Supervise technical staff 143 1.9 0.1 1.1 Conduct pathology peer review 142 1.5 0.1 1.3 Resolve discrepancies using pathology working groups and external experts 142 1.0 0.1 1.1 Provide results in accordance with SOPs or scientific principles 142 1.6 0.1 1.2 Author standard operating procedures 143 1.0 0.1 1.1 Conduct laboratory inspections 141 0.7 0.1 0.9


113



Table 32: Point of Acquisition for Tasks Within Anatomic Element of Practice VI (Public Health and Risk Management)


0 50 35.5 1 22 15.6

Monitor disease trends using databases and networking 2 69 48.9

0 27 19.1 1 51 36.2

Recognize novel manifestations of disease

2 63 44.7 0 40 28.4 1 47 33.3

Train others to detect disease threats

2 54 38.3 0 33 23.4 1 58 41.1

Detect diseases that threaten public or animal health 2 50 35.5

0 41 29.1 1 56 39.7

Report disease occurrence

2 44 31.2 0 52 36.9 1 26 18.4

Develop rational disease mitigation strategy

2 63 44.7 0 38 26.8 1 23 16.2

Characterize responses in animals to provide risk assessment 2 81 57.0

0 45 31.9 1 29 20.6

Integrate animal disease and population management information to improve risk assessment 2 67 47.5


114



Table 33: Criticality of Tasks Within Anatomic Element of Practice VI (Public Health and Risk Management)


Std. Dev.

Monitor disease trends using databases and networking 138 1.6 0.1 1.4 Recognize novel manifestations of disease 140 2.0 0.1 1.3 Train others to detect disease threats 140 1.8 0.1 1.3 Detect diseases that threaten public or animal health 139 2.1 0.1 1.4 Report disease occurrence 140 2.0 0.1 1.6 Develop rational disease mitigation strategy 139 1.5 0.1 1.3 Characterize responses in animals to provide risk assessment 138 2.2 0.1 1.5 Integrate animal disease and population management information with animal population management 136 1.6 0.1 1.3

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 34: Frequency of Tasks Within Anatomic Element of Practice VI (Public Health and Risk Management)


Std. Dev.

Monitor disease trends using databases and networking 138 0.7 0.1 0.9 Recognize novel manifestations of disease 140 1.1 0.1 0.9 Train others to detect disease threats 140 1.3 0.1 1.3 Detect diseases that threaten public or animal health 139 1.2 0.1 1.2 Report disease occurrence 140 0.9 0.1 1.1 Develop rational disease mitigation strategy 139 0.5 0.1 0.7 Characterize responses in animals to provide risk assessment 138 1.6 0.1 1.6 Integrate animal disease and population management information with animal population management 136 0.9 0.1 1.1


115



Table 35: Point of Acquisition for Tasks Within Anatomic Element of Practice VII (Education and Professional Development)


0 22 15.5 1 35 24.6


0 27 19.0 1 33 23.2

Educate regulators, other scientists, and officials

2 82 57.7 0 35 24.8 1 21 14.9

Serve as an expert consultant

2 85 60.3 0 18 12.7 1 56 39.4

Instruct professionals to advance the discipline of pathology 2 68 47.9

0 9 6.3 1 89 62.7

Promote personal and professional development

2 44 31.0 0 21 14.9 1 38 27.0

Mentor others regarding organizations and career opportunities 2 82 58.2

0 15 10.6 1 58 40.8

Train others in veterinary pathology to impart technical proficiency 2 69 48.6

0 23 16.2 1 64 45.1

Train personnel in safe specimen handling

2 55 38.7 0 41 28.9 1 10 7.0


2 91 64.1 0 29 20.6 1 58 41.1

Model the responsible conduct of research

2 54 38.3 0 50 35.5 1 13 9.2

Mentor graduate students and postdoctoral trainees in research 2 78 55.3


116



Table 36: Criticality of Tasks Within Anatomic Element of Practice VII (Education and Professional Development)


Std. Dev.

Conduct reviews of designs, proposals, results, and manuscripts 141 1.8 0.1 1.1 Educate regulators, other scientists, and officials 141 1.6 0.1 1.0 Serve as an expert consultant 139 1.7 0.1 1.2 Instruct professionals to advance the discipline of pathology 141 1.8 0.1 1.1 Promote personal and professional development 141 1.7 0.1 1.0 Mentor others regarding organizations and career opportunities 139 1.6 0.1 1.1 Train others in veterinary pathology to impart technical proficiency 140 1.9 0.1 1.0 Train personnel in safe specimen handling 140 2.1 0.1 1.2 Serve on professional and scientific committees 140 1.1 0.1 1.0 Model the responsible conduct of research 138 1.9 0.1 1.2 Mentor graduate students and postdoctoral trainees in research 138 1.3 0.1 1.2

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 37: Frequency of Tasks Within Anatomic Element of Practice VII (Education and Professional Development)


Std. Dev.

Conduct reviews of designs, proposals, results, and manuscripts 141 1.6 0.1 1.1 Educate regulators, other scientists, and officials 141 1.4 0.1 1.1 Serve as an expert consultant 139 1.1 0.1 1.2 Instruct professionals to advance the discipline of pathology 141 2.0 0.1 1.4 Promote personal and professional development 141 2.1 0.1 0.9 Mentor others regarding organizations and career opportunities 140 1.8 0.1 1.1 Train others in veterinary pathology to impart technical proficiency 140 2.1 0.1 1.1 Train personnel in safe specimen handling 140 1.7 0.1 1.1 Serve on professional and scientific committees 140 0.9 0.1 0.9 Model the responsible conduct of research 138 1.9 0.1 1.4 Mentor graduate students and postdoctoral trainees in research 138 1.1 0.1 1.2


117



Anatomic Foundational Sciences Table 38: Point of Acquisition for Anatomic Foundational Sciences


0 2 1.4 1 129 93.5

Anatomy and Physiology

2 7 5.1 0 6 4.3 1 123 89.1 Biology 2 9 6.5 0 16 11.6 1 114 82.6 Physical Sciences 2 8 5.8 0 12 8.7 1 99 71.7


0 6 4.4 1 112 81.8 Medicine 2 19 13.9 0 3 2.2 1 128 92.8 Pathology 2 7 5.1 0 8 5.8 1 119 86.9

Microbiology and Infectious Disease

2 10 7.3 1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Table 39: Criticality of Anatomic Foundational Sciences


Mean1 SEM

Std. Dev.



118



Table 40: Frequency of Anatomic Foundational Sciences

Foundational Sciences N

Mean1 SEM

Std. Dev.


1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Specific Sciences Within Anatomic Foundational Sciences Table 41: Criticality of Specific Sciences in Anatomic Foundational Science I: Anatomy and Physiology


Std. Dev.

Macroscopic Anatomy 144 2.9 0.1 1.0 Microscopic Anatomy 144 3.3 0.1 0.9

• Histology 144 3.2 0.1 1.0 • Cytology 144 1.7 0.1 1.0 • Ultrastructure 144 1.6 0.1 1.1

Physiology 144 2.3 0.1 1.0 Immunology 144 2.2 0.1 0.9

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 41: Criticality of Specific Sciences in Anatomic Foundational Science II: Biology


Std. Dev.

Zoology 144 1.4 0.1 1.0 Cell and Molecular Biology 144 2.4 0.1 1.0 Developmental Biology 144 1.5 0.1 1.0 Genetics 144 1.6 0.1 1.0 Ecology 144 0.9 0.1 0.9


119



Table 42: Criticality of Specific Sciences in Anatomic Foundational Science III: Physical Sciences


Std. Dev.

Biochemistry 144 1.8 0.1 1.1 Organic Chemistry 144 1.1 0.1 0.9 Inorganic Chemistry 144 1.0 0.1 0.8 Physics 144 0.8 0.1 0.8

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 43: Criticality of Specific Sciences in Anatomic Foundational Science IV: Applied Mathematics and Statistics


Std. Dev.

Biostatistics 144 1.8 0.1 1.0 Bioinformatics 144 1.2 0.1 0.9 Epidemiology 144 1.4 0.1 1.0

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 44: Criticality of Specific Sciences in Anatomic Foundational Science V: Medicine


Std. Dev.

Pharmacology 144 1.8 0.1 1.0 Toxicology 144 2.5 0.1 1.0 Diagnostic Imaging 144 1.6 0.1 1.0 Comparative Medicine 144 2.3 0.1 1.0

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 45: Criticality of Specific Sciences in Anatomic Foundational Science VI: Pathology


Std. Dev.

General Pathology 144 3.0 0.1 1.0 Systemic Pathology 144 3.3 0.1 0.9 Clinical Pathology 144 2.4 0.1 1.0 Cell and Molecular Pathology 144 2.5 0.1 1.1

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 46: Criticality of Specific Sciences in Anatomic Foundational Science VII: Microbiology and Infectious Disease


Std. Dev.

Virology 143 2.2 0.1 1.1 Bacteriology 143 2.2 0.1 1.1 Mycology 143 1.9 0.1 1.1 Parasitology 143 2.0 0.1 1.1


120



Evaluation of Anatomic Tools Table 47: Point of Acquisition for Anatomic Tools

Frequency Analysis for Tools: Acquisition Scale Rating1 Frequency Percent Histology/Cytology

0 1 0.7 1 130 92.9

Light Microscopy (Standard HE)

2 9 6.4 0 23 16.4 1 109 77.9


2 8 5.7 0 5 3.6 1 127 90.7


0 3 2.1 1 125 89.3


2 12 8.6 0 46 32.9 1 50 35.7 In Situ Hybridization 2 44 31.4 0 14 10.0 1 102 72.9

Photomicroscopy

2 24 17.1 Clinical Pathology

0 15 10.8 1 115 82.7


2 9 6.5 0 15 10.8 1 115 82.7


2 9 6.5 0 22 15.8 1 110 79.1


2 7 5.0 0 85 61.2 1 36 25.9


2 18 12.9 0 89 64.0 1 32 23.0


2 18 12.9 0 92 66.2 1 30 21.6



121







0 45 32.4 1 52 37.4


2 42 30.2 0 31 22.3 1 81 58.3


2 27 19.4 0 74 53.2 1 23 16.5


2 42 30.2 0 68 48.9 1 30 21.6


2 41 29.5 0 61 43.9 1 22 15.8

Confocal Microscopy

2 56 40.3 0 65 46.8 1 14 10.1


2 60 43.2 0 96 69.1 1 3 2.2



0 86 61.9 1 27 19.4


0 62 44.6 1 26 18.7


2 51 36.7 0 105 75.5 1 3 2.2



122






2 57 41.0 0 92 66.2 1 16 11.5 Spectrophotometry 2 31 22.3 0 72 51.8 1 29 20.9 Cell Culture 2 38 27.3 0 73 52.5 1 13 9.4

Telepathology

2 53 38.1 0 94 67.6 1 9 6.5



0 35 25.2 1 69 49.6


2 35 25.2 0 68 48.9 1 24 17.3

Gene Microarray

2 47 33.8 0 90 64.7 1 13 9.4

Protein Microarray

2 36 25.9 0 79 56.8 1 17 12.2

Tissue Microarray

2 43 30.9 0 87 62.6 1 17 12.2


2 35 25.2 0 65 46.8 1 35 25.2



123







1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Table 48: Criticality of Anatomic Tools

Tools N Mean1 SEM

Std. Dev.

Histology/Cytology Light Microscopy (Standard HE) 140 3.5 0.1 0.8 Cytology (standard Wright-Giemsa) 139 1.7 0.1 1.1 Histochemistry/Cytochemistry(Special Stains) 139 2.5 0.1 1.0 Immunohistochemistry/Immunocytochemistry 140 2.5 0.1 1.0 In Situ Hybridization 138 1.3 0.1 1.1 Photomicroscopy 139 1.6 0.1 1.1 Clinical Pathology Clinical Chemistry Interpretation 139 2.1 0.1 1.1 Hematology Interpretation 139 2.0 0.1 1.1 Urinalysis Interpretation 139 1.7 0.1 1.1 Clinical Chemistry Analyzers 138 0.7 0.1 1.0 Hematology Analyzers 138 0.6 0.1 1.0 Coagulation Analyzers 138 0.6 0.1 1.0 Blood Gas Analyzers 138 0.6 0.1 0.9 Immunoassay Analyzers 138 0.6 0.1 0.9 Special Microscopy Techniques Fluorescence Microscopy 137 1.2 0.1 1.1 Transmission Electron Microscopy 138 1.5 0.1 1.1 Immunoelectron Microscopy 137 0.6 0.1 0.8 Scanning Electron Microscopy 137 0.8 0.1 0.9 Confocal Microscopy 137 0.8 0.1 0.9 Computer-Aided Slide Analysis 137 0.8 0.1 0.9 Intravital Microscopy 137 0.4 0.1 0.7


124



Table 48 (Continued): Criticality of Anatomic Tools

Tools N Mean1 SEM

Std. Dev.

Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) 137 0.6 0.1 0.9 Computer-Based Image Analysis 137 0.9 0.1 1.0 Computer Modeling of Biological System/ Organisms/Organs 137 0.3 0.1 0.7 Flow Cytometry 137 0.8 0.1 0.9 Laser Capture Microdissection 137 0.7 0.1 0.9 Spectrophotometry 137 0.4 0.1 0.8 Cell Culture 137 0.6 0.1 0.9 Telepathology 138 0.6 0.1 0.9 In Vivo Imaging (e.g., bioluminescence) 137 0.5 0.1 0.8 Biochemical and Molecular Techniques/ Tools

PCR and Related Molecular Techniques 139 1.3 0.1 1.2 Gene Microarray 137 0.7 0.1 0.9 Protein Microarray 137 0.4 0.1 0.8 Tissue Microarray 137 0.6 0.1 0.8 Gene Regulation/Mutagenesis 137 0.6 0.1 0.9 Western Blotting and Related Proteomic Techniques 137 0.7 0.1 0.9 FISH/Cytogenetics 137 0.5 0.1 0.8 Immunoassays (Radioimmunodiffusion Assays, ELISA, etc.) 138 1.0 0.1 1.1 pH Assays 137 0.5 0.1 0.9 Electrophoresis 137 0.7 0.1 0.9

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 49: Frequency of Anatomic Tools

Tools N Mean1 SEM

Std. Dev.

Histology/Cytology Light Microscopy Standard HE 138 3.9 0.0 0.4 Cytology (standard Wright-Giemsa) 138 1.6 0.1 1.2 Histochemistry/Cytochemistry(Special Stains) 138 2.6 0.1 1.1 Immunohistochemistry/Immunocytochemistry 138 2.6 0.1 1.1 In Situ Hybridization 137 0.6 0.1 0.8 Photomicroscopy 138 2.2 0.1 1.2

125



Table 49 (Continued): Frequency of Anatomic Tools

Tools N Mean1 SEM

Std. Dev.

Clinical Pathology Clinical Chemistry Interpretation 138 2.0 0.1 1.2 Hematology Interpretation 138 2.0 0.1 1.2 Urinalysis Interpretation 138 1.6 0.1 1.2 Clinical Chemistry Analyzers 137 0.5 0.1 1.0 Hematology Analyzers 137 0.5 0.1 1.0 Coagulation Analyzers 137 0.4 0.1 0.9 Blood Gas Analyzers 137 0.3 0.1 0.7 Immunoassay Analyzers 137 0.4 0.1 0.7 Special Microscopy Techniques Fluorescence Microscopy 136 0.9 0.1 1.0 Transmission Electron Microscopy 137 1.0 0.1 0.8 Immunoelectron Microscopy 136 0.2 0.0 0.5 Scanning Electron Microscopy 136 0.4 0.1 0.7 Confocal Microscopy 136 0.5 0.1 0.8 Computer-Aided Slide Analysis 136 0.6 0.1 0.8 Intravital Microscopy 136 0.1 0.0 0.4 Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) 136 0.5 0.1 0.8 Computer-Based Image Analysis 136 0.7 0.1 0.9 Computer Modeling of Biological System/ Organisms/Organs 136 0.1 0.0 0.3 Flow Cytometry 136 0.7 0.1 0.9 Laser Capture Microdissection 136 0.4 0.1 0.7 Spectrophotometry 136 0.3 0.1 0.7 Cell Culture 136 0.7 0.1 1.2 Telepathology 137 0.5 0.1 0.9 In Vivo Imaging (e.g., bioluminescence) 136 0.2 0.0 0.5 Biochemical and Molecular Techniques/ Tools



126



Elements of Practice for Veterinary Clinical Pathologists Clinical Elements of Practice Table 50: Point of Acquisition for Clinical Elements of Practice

Element of Practice Rating1 Count Percent 0 7 16.7 1 29 69.0


0 0 0.0 1 37 90.2

II. Data Collection, Analysis, and Interpretation 2 4 9.8

0 1 2.6 1 34 87.2 III. Communication

and Reporting 2 4 10.3 0 1 2.6 1 25 65.8 IV. Quality Assurance 2 12 31.6 0 6 16.2 1 18 48.6

V. Public Health and Risk Management

2 13 35.1 0 2 5.6 1 25 69.4

VI. Education and Professional Development 2 9 25.0

1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Table 51: Criticality of Clinical Elements of Practice


Mean1 SEM

Std. Dev.



127



Table 52: Frequency of Clinical Elements of Practice


Mean1 SEM

Std. Dev.


1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Tasks Within Clinical Elements of Practice Table 53: Point of Acquisition for Tasks Within Clinical Element of Practice I (Research and Investigative Design)


0 8 19.0 1 26 61.9

Gather technical and scientific information to optimize study results 2 8 19.0

0 8 19.0 1 21 50.0

Contribute to the study design

2 13 31.0 0 0 0.0 1 35 83.3

Instruct clinicians, technical staff, and other professionals in assay selection and sample collection 2 7 16.7

0 1 2.4 1 35 85.4

Recommend ancillary or follow-up testing

2 5 12.2 0 6 14.3 1 22 52.4

Independently construct a hypothesis-driven investigation 2 14 33.3

0 5 11.9 1 13 31.0

Develop investigational techniques and assays in clinical pathology 2 24 57.1


128



Table 54: Criticality of Tasks Within Clinical Element of Practice I (Research and Investigative Design)


Std. Dev.

Gather technical and scientific information to optimize study results 41 1.3 0.2 1.0 Contribute to the study design 41 1.7 0.2 1.1 Instruct clinicians, technical staff, and other professionals in assay selection and sample collection 41 2.5 0.2 1.0 Recommend ancillary or follow-up testing 41 2.2 0.2 1.1 Independently construct a hypothesis-driven investigation 41 1.1 0.1 0.9 Develop investigational techniques and assays in clinical pathology 41 1.4 0.1 0.9

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 55: Frequency of Tasks Within Clinical Element of Practice II (Research and Investigative Design)


Std. Dev.

Gather technical and scientific information to optimize study results 41 1.7 0.2 1.3 Contribute to the study design 41 1.8 0.2 1.1 Instruct clinicians, technical staff, and other professionals in assay selection and sample collection 41 3.1 0.1 0.9 Recommend ancillary or follow-up testing 41 3.0 0.2 1.0 Independently construct a hypothesis-driven investigation 41 1.2 0.2 1.0 Develop investigational techniques and assays in clinical pathology 41 1.3 0.1 0.9


129



Table 56: Point of Acquisition for Tasks Within Clinical Element of Practice II (Data Collection, Analysis, and Interpretation)


0 0 0.0 1 36 87.8

Understand the principles of current pathology instrumentation 2 5 12.2

0 7 17.1 1 31 75.6

Collect samples using appropriate methods

2 3 7.3 0 2 4.9 1 36 87.8

Direct the collection of samples

2 3 7.3 0 0 0.0 1 36 87.8

Describe light and electron microscopic observations 2 5 12.2

0 1 2.4 1 35 85.4

Interpret light and electron microscopic observations 2 5 12.2

0 0 0.0 1 37 90.2 Describe hematological

and hemostasis data 2 4 9.8 0 0 0.0 1 37 90.2

Interpret hematological and hemostasis data

2 4 9.8 0 1 2.4 1 37 90.2

Describe clinical chemistry data

2 3 7.3 0 0 0.0 1 37 90.2

Interpret clinical chemistry data

2 4 9.8 0 1 2.4 1 37 90.2

Describe data generated from the analysis of urine and other body fluids 2 3 7.3

0 0 0.0 1 37 90.2

Interpret data generated from the analysis of urine and other body fluids 2 4 9.8

0 5 12.2 1 31 75.6

Describe data generated from immunoassays

2 5 12.2 0 4 9.8 1 32 78.0 Interpret data generated

from immunoassays 2 5 12.2


130



Table 56 (Continued): Point of Acquisition for Tasks Within Clinical Element of Practice II (Data Collection, Analysis, and Interpretation)


0 7 17.1 1 15 36.6

Utilize molecular methods and novel testing techniques 2 19 46.3

0 1 2.4 1 28 68.3

Utilize specialized microscopic techniques

2 12 29.3 0 7 17.1 1 23 56.1

Archive samples and/or related data

2 11 26.8 0 5 12.2 1 29 70.7

Apply proper statistical tests

2 7 17.1 0 1 2.4 1 34 82.9

Provide a contextual interpretation


131



Table 57: Criticality of Tasks Within Clinical Element of Practice II (Data Collection, Analysis, and Interpretation)

Tasks Within Element of Practice II N Mean SEM

Std. Dev.

Understand the principles of current pathology instrumentation 41 2.3 0.2 1.0 Collect samples using appropriate methods 41 1.8 0.2 1.3 Direct the collection of samples 41 2.2 0.2 1.0 Describe light and electron microscopic observations 41 2.4 0.2 1.1 Interpret light and electron microscopic observations 41 2.9 0.2 1.0 Describe hematological and hemostasis data 41 2.6 0.1 0.9 Interpret hematological and hemostasis data 41 3.0 0.1 0.9 Describe clinical chemistry data 41 2.4 0.2 1.0 Interpret clinical chemistry data 41 2.8 0.1 0.9 Describe data generated from the analysis of urine and other body fluids 41 2.5 0.2 1.0 Interpret data generated from the analysis of urine and other body fluids 41 2.9 0.1 0.9 Describe data generated from immunoassays 41 2.0 0.2 1.1 Interpret data generated from immunoassays 41 2.4 0.2 1.0 Utilize molecular methods and novel testing techniques 41 1.7 0.2 1.2 Utilize specialized microscopic techniques 41 2.0 0.1 0.9 Archive samples and/or related data 41 1.7 0.2 1.2 Apply proper statistical tests 41 1.8 0.2 1.0 Provide a contextual interpretation 41 2.5 0.2 1.1

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 58: Frequency of Tasks Within Clinical Element of Practice II (Data Collection, Analysis, and Interpretation)


Std. Dev.

Understand the principles of current pathology instrumentation 41 3.1 0.1 0.9 Collect samples using appropriate methods 41 2.0 0.2 1.4 Direct the collection of samples 41 2.7 0.2 1.1 Describe light and electron microscopic observations 41 3.3 0.2 1.2 Interpret light and electron microscopic observations 41 3.4 0.2 1.1 Describe hematological and hemostasis data 41 3.4 0.1 0.9 Interpret hematological and hemostasis data 41 3.6 0.1 0.7 Describe clinical chemistry data 41 3.0 0.2 1.3 Interpret clinical chemistry data 41 3.2 0.2 1.1


132



Table 58 (Continued): Frequency of Tasks Within Clinical Element of Practice II (Data Collection, Analysis, and Interpretation)


Std. Dev.

Describe data generated from the analysis of urine and other body fluids 41 3.4 0.2 1.0 Interpret data generated from the analysis of urine and other body fluids 41 3.4 0.1 0.9 Describe data generated from immunoassays 41 2.1 0.2 1.3 Interpret data generated from immunoassays 41 2.3 0.2 1.3 Utilize molecular methods and novel testing techniques 41 1.4 0.2 1.2 Utilize specialized microscopic techniques 41 1.9 0.1 0.9 Archive samples and/or related data 41 2.4 0.3 1.6 Apply proper statistical tests 41 1.4 0.1 0.9 Provide a contextual interpretation 41 3.0 0.2 1.3

1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Table 59: Point of Acquisition for Tasks Within Clinical Element of Practice III (Communication and Reporting)


0 0 0.0 1 36 90.0

Write clinical pathology reports

2 4 10.0 0 5 12.5 1 29 72.5 Author manuscripts 2 6 15.0 0 2 5.0 1 30 75.0

Deliver scientific or technical presentations

2 8 20.0 0 0 0.0 1 36 90.0

Communicate the significance of clinical pathology results 2 4 10.0

0 8 20.0 1 7 17.5

Respond to formal inquiries from regulatory agencies or other groups 2 25 62.5

0 0 0.0 1 30 75.0

Communicate clinical pathology knowledge


133



Table 60: Criticality of Tasks Within Clinical Element of Practice III (Communication and Reporting)


Std. Dev.

Write clinical pathology reports 40 2.8 0.2 1.0 Author manuscripts 40 1.5 0.2 1.1 Deliver scientific or technical presentations 40 1.7 0.2 1.1 Communicate the significance of clinical pathology results 40 2.8 0.2 1.1 Respond to formal inquiries from regulatory agencies or other groups 40 2.1 0.2 1.4 Communicate clinical pathology knowledge 40 2.5 0.1 0.9

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 61: Frequency of Tasks Within Clinical Element of Practice III (Communication and Reporting)


Std. Dev.

Write clinical pathology reports 40 3.7 0.1 0.8 Author manuscripts 40 1.5 0.1 0.9 Deliver scientific or technical presentations 40 1.9 0.1 0.9 Communicate the significance of clinical pathology results 40 3.2 0.2 1.1 Respond to formal inquiries from regulatory agencies or other groups 40 1.0 0.2 1.2 Communicate clinical pathology knowledge 40 3.1 0.2 1.0


134



Table 62: Point of Acquisition for Tasks Within Clinical Element of Practice IV (Quality Assurance)


0 6 15.4 1 16 41.0

Define standard operating procedures

2 17 43.6 0 2 5.1 1 17 43.6

Evaluate specimens, reagents, instruments, and personnel training to ensure validity of data 2 20 51.3

0 1 2.6 1 24 61.5

Evaluate data for evidence of preanalytical and analytical error 2 14 35.9

0 4 10.3 1 19 48.7

Resolve quality assurance problems

2 16 41.0 0 10 25.6 1 7 17.9

Develop and improve assays

2 22 56.4 0 3 7.7 1 14 35.9

Conduct reviews of reports and manuscripts

2 22 56.4 1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Table 63: Criticality of Tasks Within Clinical Element of Practice IV (Quality Assurance)


Std. Dev.

Define standard operating procedures 39 2.3 0.2 1.2 Evaluate specimens, reagents, instruments, and personnel training to ensure validity of data 39 2.4 0.2 1.1 Evaluate data for evidence of preanalytical and analytical error 39 2.4 0.2 1.1 Resolve quality assurance problems 39 2.3 0.2 1.2 Develop and improve assays 39 1.5 0.2 1.3 Conduct reviews of reports and manuscripts 39 1.9 0.2 1.1


135



Table 64: Frequency of Tasks Within Clinical Element of Practice IV (Quality Assurance)


Std. Dev.

Define standard operating procedures 39 1.6 0.2 1.1 Evaluate specimens, reagents, instruments, and personnel training to ensure validity of data 39 2.1 0.2 1.2 Evaluate data for evidence of preanalytical and analytical error 39 2.4 0.2 1.2 Resolve quality assurance problems 39 1.8 0.2 1.2 Develop and improve assays 39 0.9 0.2 1.1 Conduct reviews of reports and manuscripts 39 1.6 0.2 1.0

1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Table 65: Point of Acquisition for Tasks Within Clinical Element of Practice V (Public Health and Risk Management)


0 9 23.7 1 15 39.5

Design safe sample hand-ling protocols for infectious and toxic agents 2 14 36.8

0 13 34.2 1 8 21.1

Design protocols to manage chemicals and laboratory waste 2 17 44.7

0 9 23.7 1 17 44.7

Recognize the public health significance of infectious agents 2 12 31.6

0 17 44.7 1 7 18.4

Design clinical pathology testing strategies for disease surveillance 2 14 36.8

0 11 28.9 1 14 36.8

Integrate clinical and comparative pathology data to understand implications 2 13 34.2


136



Table 66: Criticality of Tasks Within Clinical Element of Practice V (Public Health and Risk Management)


Std. Dev.

Design safe sample handling protocols for infectious and toxic agents 38 2.1 0.3 1.6 Design protocols to manage chemicals and laboratory waste 38 1.8 0.2 1.5 Recognize the public health significance of infectious agents 38 2.0 0.3 1.6 Design clinical pathology testing strategies for disease surveillance 38 1.4 0.2 1.4 Integrate clinical pathology and comparative pathology data to understand implications 38 1.7 0.2 1.4

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 67: Frequency of Tasks Within Clinical Element of Practice V (Public Health and Risk Management)


Std. Dev.

Design safe sample handling protocols for infectiousad toxic agents 38 0.9 0.2 1.0 Design protocols to manage chemicals and laboratory waste 38 0.7 0.2 1.0 Recognize the public health significance of infectious agents 38 0.9 0.2 1.0 Design clinical pathology testing strategies for disease surveillance 38 0.4 0.1 0.8 Integrate clinical pathology and comparative pathology data to understand implications 38 1.0 0.2 1.2


137



Table 68: Point of Acquisition for Tasks Within Clinical Element of Practice VI (Education and Professional Development)


0 7 19.4 1 27 75.0

Instruct veterinary students

2 2 5.6 0 4 11.1 1 15 41.7

Instruct veterinary pathology residents

2 17 47.2 0 3 8.3 1 14 38.9

Provide continuing education and training

2 19 52.8 0 1 2.8 1 17 47.2

Provide mentorship and guidance to trainees and colleagues 2 18 50.0

0 4 11.1 1 19 52.8

Participate in professional development activities

2 13 36.1 0 12 33.3 1 8 22.2

Provide education to the public in aspects of veterinary clinical pathology 2 16 44.4

0 6 16.7 1 4 11.1


2 26 72.2 1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Table 69: Criticality of Tasks Within Clinical Element of Practice VI (Education and Professional Development)


Std. Dev.

Instruct veterinary students 36 2.0 0.2 1.3 Instruct veterinary pathology residents 36 2.1 0.2 1.1 Provide continuing education and training 36 2.0 0.2 1.1 Provide mentorship and guidance to trainees and colleagues 36 1.7 0.2 1.0 Participate in professional development activities 36 1.5 0.2 1.1 Provide education to the public in aspects of veterinary clinical pathology 36 0.9 0.2 1.0 Serve on professional and scientific committees 36 1.1 0.2 0.9


138



Table 70: Frequency of Tasks Within Clinical Element of Practice VI (Education and Professional Development)


Std. Dev.

Instruct veterinary students 36 2.0 0.3 1.5 Instruct veterinary pathology residents 36 2.1 0.2 1.4 Provide continuing education and training 36 1.7 0.2 1.1 Provide mentorship and guidance to trainees and colleagues 36 2.4 0.2 1.0 Participate in professional development activities 36 1.9 0.2 1.1 Provide education to the public in aspects of veterinary clinical pathology 36 0.8 0.1 0.8 Serve on professional and scientific committees 36 1.1 0.1 0.9

1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Evaluation of Clinical Foundational Sciences Table 71: Point of Acquisition for Clinical Foundational Sciences


0 2 5.3 1 35 92.1 Anatomy 2 1 2.6 0 4 10.8 1 27 73.0


0 1 2.8 1 33 91.7 Biology/Pathology 2 2 5.6 0 0 0.0 1 33 91.7 Chemistry 2 3 8.3 0 3 8.3 1 28 77.8 Microbiology 2 5 13.9 0 1 2.8 1 32 88.9

Physiology/ Pathophysiology

2 3 8.3 0 3 8.3 1 30 83.3 Physics 2 3 8.3


139



Table 72: Criticality of Clinical Foundational Sciences


Mean1 SEM

Std. Dev.


1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 73: Frequency of Clinical Foundational Sciences

Performance Domain N

Mean1 SEM

Std. Dev.


1 Ratings: 0 = Never, 1 = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Table 74: Criticality of Specific Sciences in Clinical Foundational Science I: Anatomy


Std. Dev.

Macroscopic Anatomy 38 2.1 0.2 1.1 Microscopic Anatomy 38 2.5 0.2 1.3 Histology 38 2.2 0.2 1.2 Cytology 38 3.1 0.2 1.2 Ultrastructural Anatomy 38 1.3 0.2 1.2


140



Table 75: Criticality of Specific Sciences in Clinical Foundational Science II: Applied Mathematics and Statistics


Std. Dev.

Data Management Systems 37 1.4 0.2 1.2 Biostatistics 37 1.6 0.2 1.0 Bioinformatics 37 1.1 0.2 1.0

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 76: Criticality of Specific Sciences in Clinical Foundational Science III: Biology/Pathobiology


Std. Dev.

Cell Biology 36 1.9 0.2 1.0 Developmental Biology and Aging 36 1.4 0.2 0.9 Genetics 36 1.4 0.1 0.9 Immunology 36 2.2 0.2 1.1 Molecular Biology 36 1.8 0.2 1.1 Cancer Biology 36 2.2 0.2 1.2

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 77: Criticality of Specific Sciences in Clinical Foundational Science IV: Chemistry


Std. Dev.

Biochemistry 36 2.0 0.2 1.0 Clinical Chemistry 36 3.0 0.2 0.9

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 78: Criticality of Specific Sciences in Clinical Foundational Science V: Microbiology


Std. Dev.

Mycology 36 1.9 0.2 1.0 Virology 36 1.9 0.2 1.0 Parasitology 36 2.0 0.1 0.9 Bacteriology 36 2.2 0.2 0.9


141



Table 79: Criticality of Specific Sciences in Clinical Foundational Science VI: Physiology/ Pathophysiology


Std. Dev.

Biotransformation 36 1.2 0.2 1.0 Endocrinology 36 2.7 0.2 1.0 Hematology 36 3.1 0.2 0.9 Metabolism 36 2.2 0.2 1.1 Reproduction 36 1.6 0.2 0.9 Pharmacology 36 1.4 0.2 1.0 Nutrition 36 1.1 0.1 0.8 Toxicology 36 1.8 0.2 1.2

1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 80: Criticality of Specific Sciences in Clinical Foundational Science VII: Physics

Specific Science N Mean1 SEM

Std. Dev.

Instrumentation 36 2.1 0.2 1.1 1 Ratings: 0 = No harm or not applicable, 1 = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm

142



Evaluation of Tools Table 81: Point of Acquisition for Clinical Tools

Frequency Analysis for Tools: Acquisition Scale Rating1 Count Percent Histology/Cytology

0 2 5.6 1 32 88.9

Light Microscopy Standard HE

2 2 5.6 0 0 0.0 1 33 91.7


2 3 8.3 0 5 13.9 1 26 72.2


0 4 11.1 1 26 72.2


2 6 16.7 0 20 55.6 1 6 16.7 In Situ Hybridization 2 10 27.8 0 8 22.2 1 23 63.9 Photomicroscopy 2 5 13.9

Clinical Pathology 0 0 0.0 1 32 88.9


2 4 11.1 0 1 2.8 1 31 86.1


2 4 11.1 0 1 2.8 1 31 86.1


2 4 11.1 0 0 0.0 1 29 80.6


2 7 19.4 0 0 0.0 1 29 80.6


2 7 19.4 0 3 8.3 1 26 72.2



143







0 16 44.4 1 8 22.2


2 12 33.3 0 16 44.4 1 11 30.6


2 9 25.0 0 22 61.1 1 5 13.9


2 9 25.0 0 20 55.6 1 8 22.2


2 8 22.2 0 20 55.6 1 7 19.4 Confocal Microscopy 2 9 25.0 0 18 50.0 1 5 13.9


2 13 36.1 0 23 63.9 1 5 13.9



0 25 69.4 1 7 19.4


0 20 55.6 1 7 19.4


2 9 25.0 0 25 69.4 1 6 16.7



144






2 8 22.2 0 13 36.1 1 18 50.0 Spectrophotometry 2 5 13.9 0 22 61.1 1 5 13.9 Cell Culture 2 9 25.0 0 17 47.2 1 4 11.1 Telepathology 2 15 41.7 0 25 69.4 1 3 8.3



0 11 30.6 1 16 44.4


2 9 25.0 0 25 69.4 1 6 16.7 Gene Microarray 2 5 13.9 0 25 69.4 1 7 19.4 Protein Microarray 2 4 11.1 0 25 69.4 1 5 13.9

Tissue Microarray

2 6 16.7 0 25 69.4 1 6 16.7


2 5 13.9 0 16 44.4 1 11 30.6



145







1 Ratings: 0 = not applicable, 1 = expected of new diplomates, 2 = acquired after board certification is earned Table 82: Criticality of Clinical Tools

Tools N Mean1 SEM

Std. Dev.

Histology/Cytology Light Microscopy Standard HE 36 2.3 0.2 1.3 Cytology (standard Wright-Giemsa) 36 3.0 0.2 1.1 Histochemistry/Cytochemistry(Special Stains) 36 1.8 0.2 1.1 Immunohistochemistry/Immunocytochemistry 36 1.9 0.2 1.2 In Situ Hybridization 36 0.8 0.2 1.2 Photomicroscopy 36 1.1 0.2 1.1 Clinical Pathology Clinical Chemistry Interpretation 36 2.9 0.2 1.0 Hematology Interpretation 36 2.9 0.2 1.0 Urinalysis Interpretation 36 2.7 0.2 1.2 Clinical Chemistry Analyzers 36 2.2 0.2 1.2 Hematology Analyzers 36 2.3 0.2 1.2 Coagulation Analyzers 36 1.9 0.2 1.2 Blood Gas Analyzers 36 1.7 0.2 1.3 Immunoassay Analyzers 36 1.4 0.2 1.2 Special Microscopy Techniques Fluorescence Microscopy 36 0.7 0.2 1.0 Transmission Electron Microscopy 36 0.6 0.1 0.9 Immunoelectron Microscopy 36 0.4 0.1 0.8 Scanning Electron Microscopy 36 0.4 0.1 0.7 Confocal Microscopy 36 0.5 0.1 0.7 Computer-Aided Slide Analysis 36 0.6 0.2 0.9 Intravital Microscopy 36 0.3 0.1 0.6


146



Table 83 (Continued): Criticality of Clinical Tools

Tools

N

Mean1

SEM

Std. Dev.

Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) 36 0.6 0.2 0.9 Computer-Based Image Analysis 36 0.6 0.2 1.0 Computer Modeling of Biological System/ Organisms/Organs 36 0.4 0.1 0.8 Flow Cytometry 36 1.8 0.2 1.3 Laser Capture Microdissection 36 0.5 0.1 0.8 Spectrophotometry 36 1.1 0.2 1.2 Cell Culture 36 0.4 0.1 0.8 Telepathology 36 0.8 0.2 1.2 In Vivo Imaging (e.g., bioluminescence) 36 0.2 0.1 0.5 Biochemical and Molecular Techniques/ Tools



147




Tools N Mean1 SEM

Std. Dev.

Histology/Cytology Light Microscopy Standard HE 36 2.6 0.2 1.2 Cytology (standard Wright-Giemsa) 36 3.7 0.1 0.8 Histochemistry/Cytochemistry(Special Stains) 36 1.7 0.2 1.1 Immunohistochemistry/Immunocytochemistry 36 1.9 0.2 1.1 In Situ Hybridization 36 0.3 0.1 0.6 Photomicroscopy 36 1.7 0.2 1.2 Clinical Pathology Clinical Chemistry Interpretation 36 3.5 0.1 0.8 Hematology Interpretation 36 3.7 0.1 0.7 Urinalysis Interpretation 36 3.4 0.2 1.0 Clinical Chemistry Analyzers 36 2.5 0.2 1.0 Hematology Analyzers 36 2.7 0.1 0.9 Coagulation Analyzers 36 1.9 0.2 1.2 Blood Gas Analyzers 36 1.5 0.2 1.1 Immunoassay Analyzers 36 1.1 0.2 1.2 Special Microscopy Techniques Fluorescence Microscopy 36 0.5 0.2 1.0 Transmission Electron Microscopy 36 0.4 0.1 0.7 Immunoelectron Microscopy 36 0.1 0.1 0.4 Scanning Electron Microscopy 36 0.2 0.1 0.5 Confocal Microscopy 36 0.4 0.1 0.8 Computer-Aided Slide Analysis 36 0.4 0.1 0.7 Intravital Microscopy 36 0.1 0.1 0.4 Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) 36 0.4 0.2 1.0 Computer-Based Image Analysis 36 0.3 0.1 0.7 Computer Modeling of Biological System/ Organisms/Organs 36 0.1 0.1 0.5 Flow Cytometry 36 1.4 0.2 1.1 Laser Capture Microdissection 36 0.3 0.1 0.6 Spectrophotometry 36 0.8 0.2 1.0 Cell Culture 36 0.4 0.1 0.9 Telepathology 36 0.4 0.1 0.8 In Vivo Imaging (e.g., bioluminescence) 36 0.2 0.1 0.7 Biochemical and Molecular Techniques/ Tools



148




Tools N Mean1 SEM

Std. Dev.

Western Blotting and Related Proteomic Techniques 36 0.5 0.2 0.9 FISH/Cytogenetics 36 0.1 0.1 0.5 Immunoassays (Radioimmunodiffusion Assays, ELISA, etc.) 36 1.5 0.2 1.2 pH Assays 36 1.0 0.2 1.1 Electrophoresis 36 1.8 0.2 1.0


149



Reliability Analysis of Scales for Elements of Practice Table 84: Reliability Estimates — Anatomic Elements of Practice

RELIABILITY

Element of Practice

N

# of Task

s

Acquisition

Criticality

Frequency


II. Data Collection 158 10 .84 .91 .88 III. Data Analysis and

Interpretation 151 9 .80 .86 .77

IV. Communication and Reporting 147 6 .77 .82 .73

V. Quality Assurance 144 7 .87 .87 .82 VI. Public Health and Risk

Management 141 8 .88 .90 .69

VII. Education and Professional Development 141 9 .87 .90 .78

Table 85: Reliability Estimates — Anatomic Foundational Sciences



I. Anatomy and Physiology 144 7 .84 II. Biology 144 5 .84 III. Physical Sciences 144 4 .87 IV. Applied Mathematics and


V. Medicine 144 4 .74 VI. Pathology 144 4 .84 VII. Microbiology and Infectious

Disease 143 4 .96

150



Table 86: Reliability Estimates — Clinical Elements of Practice RELIABILITY


# of Tasks

Acquisition

Criticality

Frequency


II. Data Collection, Data Analysis, and Interpretation 41 18 .87 .94 .86

III. Communication and Reporting 40 6 .501 .81 .581

IV. Quality Assurance 39 6 .76 .88 .83 V. Public Health and Risk

Management 38 5 .85 .89 .82

VI. Education and Professional Development 36 7 .84 .92 .79

1 Reliability for these topics is low, probably because of the small number of respondents. The information about when veterinary clinical pathologists acquire skills related to and how often they engage in Communication and Reporting may still have value. Table 87: Reliability Estimates — Clinical Foundational Sciences



I. Anatomy 38 5 .75 II. Applied Mathematics and

Statistics 37 3 .84

III. Biology/Pathology 36 6 .94 IV. Chemistry 36 2 .73 V. Microbiology 36 4 .93 VI. Physiology/ Pathophysiology 36 8 .90 VII. Physics --- 1 ---

151


Scope of the ACVP Certifying Examination (Phase II) – Clinical Pathology

“What an entry level clinical pathologist should know, recognize and be able to do in a clear, concise and accurate manner”

1. Identify, describe and interpret microscopic lesions in domestic and non-domestic animals • Includes inflammatory, neoplastic and other disorders that cause abnormalities in blood,

bone marrow, fluid and tissue (cytology and histology) specimens.

2. Recognize and interpret visual test results pertinent to veterinary clinical pathology

• Includes hematology cytograms, flow cytometry plots, coagulation tracings, macroscopic hematology test results (eg. Coombs tests), special and immunochemical stains, electron micrographs, method comparison charts, quality assurance and quality control data.

3. Interpret clinico-pathologic data from domestic and non-domestic animals

• Know the cause(s) of laboratory abnormalities • Integrate laboratory abnormalities into a diagnosis (or differential diagnoses) • Know appropriate ancillary tests to further refine definitive or differential diagnoses

4. Understand the pathophysiology, behavior and diagnosis of disease in animals

• Includes inflammatory, neoplastic and metabolic disorders that can be recognized and diagnosed with clinico-pathologic testing

• Requires familiarity with core concepts and current literature • Requires the ability to integrate test results (microscopic, hematologic, biochemical, etc.) and

clinical information as appropriate

5. Understand the principles of commonly used laboratory equipment and methods

• Sample types and collection methods • Analyzer and test methodologies • Microscope principles and operation • Routine, special and immunochemical stains

6. Understand fundamental principles of laboratory medicine

• Test properties (sensitivity, specificity, predictive values, ROC…) and selection • Quality assurance and quality control • Reference interval determination • Errors and interferences (including pre-analytical, analytic and post-analytical errors)

Reference

The 2008 ACVP Role Delineation Survey and Initial Data Analysis, Vet Pathol 2009;46:567-575

152

B2 Scope of the ACVP Certifying Examination - Clinical Pathology

InventionCommittee

Name CommitteeRepresented Specialty Practice

Experience1 Ackermann,Mark Council AP A2 Agnew,Dalen ExaminationCommittee AP A3 Berent,Linda CEB CP/AP A4 Bienzle,Dorothee CEB/CERC CP A5 Coleman,Gary ABVSLiaison AP G/I6 Cregar,Laura CEB CP I7 Harris,Keith CEB AP G/I/A8 Howerth,Buffy CEB/CERC AP A9 Lenz,Stephen CERCMember AP A10 Lewis,Anne CEB AP A11 Miller,Andrew ExaminationCommittee AP A12 Pinson,David CEB AP A13 Richey,Lauren CredentialingCommittee AP A14 Robinson,Nick TrainingProgramCommittee AP A15 Rudmann,Dan CEB AP I16 Simpson,Mark Council AP G17 Stromberg,Paul CEB AP A18 Webb,Julie ExaminationCommittee/CERC CP A19 Weiser,Glade CEB/CERC CP A/I20 Wellman,Maxey CEB CP A

A: Academia G: Government I: Industry

153

I1 Invention Phase Panel Participants

JobTaskAnalysis,ClinicalPathology:RefinementPhase

BackgroundTheAmericanBoardofVeterinarySpecialties(ABVS)requiresthateachconstituentspecialtycollegeorboardconductaJob/TaskAnalysis(JTA)atleastevery10years.TheABVSdefinesaJob/taskanalysisasfollows:

Job/taskanalysis—Asystematicprocedurefordefiningthetasksrequiredbyajobandtheknowledge,skills,abilities,andotherpersonalcharacteristicsrequiredofindividualsperformingthatjob.Theresultsofajob/taskanalysisformthebasisfordeterminingtheexaminationcontentsnecessarytotestmasteryofthatfield.

TheACVPconductedaRoleDelineationStudy(RDS)in2007–8,facilitatedbyDr.JimHendersonofCastleWorldwide.Resultsofthisstudywerepublishedin2009.AtestplanwasdevelopedbasedonthatstudyandtheExaminationCommittee(EC)mappedtestitemstothetestplanbeginningin2010.SuccessiveECshaverevisedthetestplantomoreaccuratelyreflectexamcontent,whilestilladheringtotheresultsoftheRDS.TheCertifyingExaminationBoard(CEB)wasformedin2011andreviewsthetestplanannually.In2012,thetestplanwasevaluatedindepthandmodifiedbyasubcommitteeoftheCEBwiththesupportofDr.JimHenderson.TheCollege’sdecisionin2015toredesignthePhaseIICEwithimplementationin2017promptedtheneedtoconductanewRDS.TheCEBelectedtouseterminology“Job/TaskAnalysis(JTA)”ratherthanRDSgoingforwardastheformerisconsistentwiththeterminologyusedbytheABVS.

In2015,theCEB,startingwiththedataandconclusionsderivedfromthe2009RDS,developedandapprovedtheScopeoftheACVPCertifyingExaminationdocumentsforthePhaseIIexaminationforanatomicandclinicalpathology.Thesedocumentsdescribethekeytasksperformedbyentry-levelveterinarypathologistsengagedinbothspecialties.

InMarch2016,theCEBdraftedadocumentoutliningtheJTAprocess,withanobjectiveofcompletingthistaskandgeneratingaBlueprintforthe2017PhaseIICEandthe2018PhaseIexaminationbythe2016AnnualMeeting.AlthoughaJob/TaskAnalysisisabestpracticeforhighstakescertifyingexaminations,thereisnosinglemethodrecommendedforconductingthisanalysis(NationalCommissionforCertifyingAgenciesStandardsfortheAccreditationofCertifyingPrograms,Standard10).TheCEB,withapprovalofACVPCouncil,electedtoconductaJTAbuildingonthedatacollectedfromthe2007-8RDS,theexperiencegainedbytheECandtheCEBoverthelast7yearsworkingwiththetestplanbasedonthatstudy,thecurrentCEtestplanmatrixandtheScopeofACVPCertifyingExaminationdocuments.TheCEBalsorecognizedthatthecompositionofthecurrentexamination,developedannuallyforoverfivedecadesbygenerationsofExaminationCommitteemembersrepresentativeoftheCollegeatlarge,representsvaluablehistoricaldatarelativetoCEcontent.

ThephasesofJTAareasfollows:

154

I2 Invention Phase Draft JTA Tasks

1. Invention.ThisphaseisconductedbytheextendedCEBwhichiscomposedof11coremembersappointedbyCounciland9adhocmembersrepresentingrelevantACVPcommittees.TheobjectiveofthisphaseistoproduceadraftJTAdocumentforsubsequentlevelsofbroaderreview.Thisdocumentwillincludeassignedpercentagesfor:1)eachofthetestableTasksidentifiedintheScopeoftheACVPCertifyingExaminationasneededfor“AbilityatEntry”anatomicpathologistsand2)“Blueprint”categoriesofspecies,organsystemandprocess”tobeappliedacrossallTasks.

2. Refinement.Inthisphase,twopanels,oneforanatomicpathology(20members)andoneforclinicalpathology(15members),willbeaskedtoreviewthedraftdocumentsandprovidefeedbacktotheCEBforrefinementconsideration.TheCEBwillselectthetwopanels,ensuringtheyarerepresentativeofthedemographicsoftheCollege.

3. Validation.Inthisphase,theACVPmembershipwillbeaskedtoparticipateinasurveyaskingfora1-3levelagreementoneachitemoftheJTA.Memberswillalsobeaskedtoprovidereasonsfordisagreements.Followingitsreviewofthemembershipsurveyresults,theCEBwillfurtherrefinetheJTA.

4. Approval.ThefinaldocumentwillbesubmittedtoCouncilforapproval.Followingapproval,theECwillusetheBlueprintsectionoftheJTAforCEdevelopmentandmapping.

TASKANDBLUEPRINTLISTSANDDRAFTCONTENTPERCENTAGESFORCLINICALPATHOLOGY


• Testedviaglassslidesandimage-basedMCQs• ~30%ofPhaseII

Skillsandknowledge:• Writeacoherent,organizeddescriptivereport• Summarizerelativetothedescriptivefindings• Interpretiveconclusion(s)and/ordiagnosis(es)• Giveappropriatedisease,condition,and/ordifferentialdiagnoses• Givepotentialcauses(s)• Giveassociatedchangesinotherorgan• Giveappropriateancillarytestsandanticipatedresults(e.g.specialstains,



• Testedviaimage-basedMCQs• ~15%ofthePhaseII

Skillsandknowledgeforinterpretationof:• Hematologycytograms• Flowcytometryplots

155


• Coagulationtracings• Macroscopichematologytestresults(eg.Coombstests)• Specialandimmunochemicalstains• Electronmicrographs• Qualityassuranceandqualitycontroldata.• PCRclonalityresults


• TestedviacaseessaysandMCQs• ~25%oftheentirePhaseIIexam.

Skillsandknowledge:

• Describepathophysiologyofconditionsleadingtolaboratoryabnormalities• Integratelaboratoryabnormalitiesintoadiagnosis(ordifferentialdiagnoses)• Knowappropriateancillaryteststofurtherconfirmdefinitiveordifferential

diagnoses• Interpretintegratedlaboratoryresults(biochemistry,urinalysis,serology,

microbiology,immunodiagnostics,coagulation,hematology,etc.)TASK4:Knowtheprinciplesofcommonlyusedlaboratoryinstrumentationandmethods


Knowledge: • Analyzerandtestproceduremethodologies• Sampletypesandcollectionmethods• Referenceintervaldetermination• Errorsandinterferences(pre-analytical,analyticandpost-analytical)• Testproperties(sensitivity,specificity,predictivevalues,ROC,etc.)andselection• Qualitycontrol,qualityassurance,biostatistics• Routine,specialandimmunochemicalstains • Microscopeprinciples,safety,biosafety

TASK5:Knowpathophysiologyanddiagnosisofdisease,withemphasisonmanifestationinlaboratorytestdata

• Testedvianon-imagebasedMCQs• ~15%ofPhaseII,~90%ofPhaseI

Knowledge:Pathogenesis,etiologyandorgan-basedcausesforthefollowingdiseaseprocesses

• Genetic • Disturbanceofgrowth/neoplasia • Cellaging/degeneration/injury/death • Infection/immunity/inflammation

156


• Metabolic/Nutritional/Deficiency • Hemodynamic/Vasculardisease

NON-TESTABLETASKS(CurrentlylistedontheCESponsorVerificationForm)




TASK7KnowandUnderstandQualityAssurance• Definestandardoperatingproceduresinaccordancewithprescribedmethodsin

ordertoensureacceptablelevelsofqualityandconsistency.• Evaluatespecimens,reagents,instruments,andpersonneltrainingbyinspection,

reviewanddocumentationinordertoensurethevalidityofdata.• Evaluatedataforevidenceofpreanalyticalandanalyticalerrorthroughinspectionin

ordertodetermineifverificationandtroubleshootingarerequiredtoobtainreliableresults.

BlueprintCategoryTargetsDistributionbySpeciesS1Domestic 70–80% S2Labanimal 12–24% S3Non-domestic 5–10% DistributionbyOrgansystem O1Hemolymphatic 20-25% O2Skin/Integument 5-10%O3Cardiovascular 2-6%O3Gastrointestinal 5-10%O4Pancreas,exocrine 2-6%05Liver 5-10%O6Endocrine 5-10%O7Renal 5-10%O8Respiratory 2-6%O9Nervousandspecialsenses 2-6%O10Musculoskeletal 2-6%O11Reproductive 2-6%O13Multiorgan/Systemic/Other 2-6%O14Non-organbased 10-20%

157


Distributionbytopic(PhaseIIExamination) C1Genetic 10–15%C2Disturbanceofgrowth/neoplasia 10–20%C3Cellaging/degeneration/injury/death 5–10%C4Infection/immunity/inflammation 30–40%C5Metabolic/Nutritional/Deficiency 5–10% C6Hemodynamic/Vasculardisease 5–10% C7LabAnalysis 10–20% Distributionbytopic(alsoappliedtothePhaseIExamination) C1Genetic 5–10%C2Disturbanceofgrowth/neoplasia 15–25%C3Cellaging/degeneration/injury/death 5–10% C4Infection/immunity/inflammation 40–60% C5Metabolic/Nutritional/Deficiency 3–5% C6Hemodynamic/Vasculardisease 5–10% C7LabAnalysis 3–5% DEFINITIONS

Blueprint(testplan):TheCEBlueprintisthedocumentdevelopedduringtheJTAandusedbytheExaminationCommitteetoselectCEcontent.TheBlueprintisbrokendownbyJTATasksandthefollowingcategories:species,organsystemanddiseaseprocess.ItincludescontentpercentageguidancebasedontheJTA.

CertifyingExaminationBoard(CEB):TheCEBwasconstitutedbyCouncilin2011andchargedtoevaluateallaspectsofthecertificationprocessandtorecommendtoCouncilcomprehensivestrategiesformaintainingandimprovingexaminationprocesses,inaccordancewithrelevantbestpracticesforprofessionalcertification.TheCEBiscurrentlycomposedof20ACVPdiplomates.Eleven“coremembers”areappointedbyCouncilandhavevotingstature.Atleastthreecoremembersmustbecertifiedinanatomicpathologyandatleastthreemustbecertifiedinclinicalpathology.NineadhocmembersrepresentcommitteesandactivitiesrelatedtotheCE,includingtheCredentialingCommittee,theExaminationCommittee,andtheTrainingProgramCommittee.OtheradhocmembersincludetheACVPliaisontotheABVS,theACVPsecretary-treasurer,andoneofthememberswhoprovideQAsupporttothePhaseIICE.

ExaminationCommittee:Committeetaskedwithdeveloping,administeringandscoringtheCertifyingExaminationsinClinicalPathologyandAnatomicPathology.

Tasks:Tasksaredefinedasthecriticalskillsandknowledgeexpectedofanentrylevelorminimallycompetentveterinarypathologist.

158


Applicationof5MappingCategoriestoSampleTestItemsfromthe2013AnatomicPathologyExaminationGlassSlides:AllCPglassslideswillfallunderTask1

CaseEssays:AllCPcaseessayswillfallunderTask3

1. Rubeanicacidstainingofhepatocyteintracytoplasmicgranulesindicates:

A. CopperB. GlycogenC. Lipofuscin D. Hemosiderin

Map:Task42. Infelinepapillomavirus-associatedsquamouscellcarcinomas,whichproteinhas

increasedexpression?A. p16B. p21C. p53D. pRb

Map:Task53. Cytologicidentificationofakinetoplasthelpsidentify:

A. CytauxzoonfelisB. NeosporacaninumC. ToxoplasmagondiiD. Leishmaniadonovani

Map:Task54. Indogs,thefollowingimmunohistochemicalprofilefromaskinmasssuggests:

Antibody ResultCD1a PositiveCD4 PositiveCD11b NegativeCD11c PositiveCD80 PositiveE-cadherin NegativeThy-1(CD90) Positive

A. HistiocyticsarcomaB. CutaneoushistiocytosisC. SolitarycutaneoushistiocytomaD. Hemophagocytichistiocyticsarcoma

159


Map:Task45. Bothreticulocytesandmatureerythrocyteshavereceptorsfor:

A. TransferrinB. FibronectinC. ComplementD. Thrombospondin

Map:Task56. Whichisthemostlikelycauseoftheselaboratoryabnormalitiesfromanadultdog?

Analyte Patient ReferenceIntervalSerumiron(μg/dl) 30 L 50-198SerumTIBC(μg/dl) 175 L 231-455Stainableironinmarrow Increased NormalSerumferritin(ng/ml) 350 H 43-261

A. HemolysisB. InflammationC. IrondeficiencyD. Corticosteroidadministration

Map:Task37. Indogs,whichconditionisassociatedwithbotryoidneutrophils?

A. HeatstrokeB. SepticshockC. HypersplenismD. Highaltitudedisease

Map:Task58. Indogs,seruminhibinisabiomarkerfor:

A. TransitionalcellcarcinomaB. AdrenocorticalcarcinomaC. HepatocellularcarcinomaD. Mammarycarcinoma

Map:Task5 9. Whichserumpatternismostconsistentwithtumorlysissyndrome?

Uricacid Potassium Phosphorus CalciumA. Low High Low HighB. High Low High LowC. Low Low Low High

160


D. High High High LowMap:Task510. WhichspecieshasthelowestcolostrumGGTactivity? A. Horses B. Sheep C. Cattle D. GoatsMap:Task511. WhatisthebestinterpretationofthisADVIAcytogramfromadog?

A. Leukocyte-plateletaggregates

B. Neutrophiliawithleftshift

C. StageVlymphoma

D. Rubricytosis

Map:Task2

161


D:diagnosticlaboratoryA:academiaI:IndustryG:Government

ClinicalPathologists

YEAROFCERTIFICATION

Name 2-5 6-15 >15 Practice

SettingPhd(Y/N)

TrainingProgram(s)

ECexperience

1 Tan,Emmeline 2009 D,IDEXX N OVC N2 Behling-Kelly,Erica 2011 A,Cornell Y Wisconsin N3 Freidrichs,Kristen 2003 A,Wisconsin N N4 Santangelo,Kelly 2012 A,CSU Y OSU N5 Aulbach,Adam 2007 I,MPI N MSU/MPI N6 Gupta,Ara 2011 I,Merial N LSU N7 Garner,Bridget 2009 A,UGA Y Misouri N8 Collins,Nate 1999 I,Celgene Y OSU N9 Thompson,Craig 2005 A,Purdue N OklaState P10 ShelleyBurton 1994 A,PEI Y PEI Y

11 BobHall 1982 I,Covance YOhioState,ColoState Y

12 BillReagan mid80's I,Pfizer Y ColoradoState N

13 Bounous,Denise ? I,BMS Y Y14 Scruggs,Jennifer 2014 G,JPC Y Tenn N15 Krimer,Paula 2002 D,AVDL(UGA) Y OVC N

162

R1 Refinement Phase Panel Participants

DearAll,

ThankyouforagreeingtoparticipateasamemberoftheACVPClinicalPathologyJobTaskAnalysis(JTA)RefinementCommittee.AsImentionedinmymessagelastFriday,thepurposeoftheJTAistodefinetheknowledgeandskillsrequiredofaminimallycompetent/entrylevelveterinaryclinicalpathologistforthepurposeofdeterminingcontentfortheACVPCertifyingExamination.

Theattacheddocumentistitled“JobTaskAnalysis,ClinicalPathology:RefinementPhase”.ThedocumentdefinesJTAanddescribestheJTAprocesstheCollegeisusing.ItalsoprovidessomehistoricalperspectiverelatingtotheJTA,startingwiththeRoleDelineationStudytheCollegeConductedin2008-2009.Finally,itincludesdraftknowledgeandskills,definedas“tasks”,andcertifyingexamination“blueprint”categories(species,organsystem,diseasetopics)developedbya20member“Invention”committee.Thereareseventasks,fiveofwhichareconsideredtestableandtwoofwhicharenon-testable.

Followingyourreviewyouwillbeasked,throughanon-linesurvey,foryouropinionregardingtheimportanceofthedrafttasks,thebalanceofitemswithinblueprintcategories,andwhetherornotyoubelieveanycriticaltaskswereoverlooked.Youwillnoticethatwehaveaskedyoutoincludeyournameonthesurvey.Webelieveweneedtobeabletoidentifythosewhohavecompletedthesurveyasameanstoensurethereisappropriatedemographicrepresentationinthisprocess.Onlythethreepeopleresponsibleforadministeringthesurveywillseethenames.Wewantandrespectallopinionsinthisprocess,sopleaseletmeknowifthisisaproblemforyou.

Thelinktothesurveyis:https://www.surveymonkey.com/r/LQ7NTKG

YouwillalsobegiventheopportunitytoparticipateinanoptionalGoToMeetingifyouhavequestions/concerns/suggestionsyouwouldliketodiscusswithmembersoftheInventionCommitteeandothermembersoftheRefinementCommittee.Wehaveset-uptwoofthesemeetings,eachatadifferenttimeofdayinordertoprovidesomeflexibilityinscheduling.Again,thesemeetingsareoptional.Youcanalsocontactme,DorotheeBienzleorGladeWeiserdirectlywithquestionsorconcerns.I’veincludedthelog-oninformationforbothGoToMeetingsbelow,followingtheRefinementCommitteeschedule.Ihavealsoincludedacall-innumber,butIrecommendyoulog-inthroughacomputer,tabletorsmartphonesoyoucantakeadvantageofGoToMeetingfeatures.

AlsoasImentionedinmymessagelastweek,letmeknowassoonaspossibleifyouareunabletoparticipateinthisactivityorifyouwouldlikemetocontactyoutodiscusstheJTAprocess.Ifyouareunabletoparticipatewewillneedtoidentifysomeonewhofitsyourdemographicstoreplaceyou;therefore,letmeknowassoonaspossibleifyoucan’tparticipate.Thesurveycompletiondeadlineis29August.Keith

JTAClinicalPathologyRefinementCommitteeSchedule

2/3August EmailwithJTAdraftskills/blueprintcategoriesdocumentandsurveylinksenttocommitteemembers

9August,1:00PMCDT GoToMeetingconferencecall(optional)11August,9:00AMCDT GoToMeetingconferencecall(optional)29August Surveycompletiondeadline

163

R2 Refinement Phase Background Information Email

ACVP Clinical Pathology Job Task Analysis Refinement Committee GoToMeeting Instructions

August 9, 2016, Tuesday

2:00 PM EDT

1:00 PM CDT

12:00 PM MDT

11:00 PM PDT

Please join my meeting from your computer, tablet or smartphone.

https://global.gotomeeting.com/join/559963381

You can also dial in using your phone.

United States : +1 (224) 501-3316

Access Code: 559-963-381

_____________________________________________________________________________________

August 11, 2016, Thursday

10:00 AM EDT

9:00 AM CDT

8:00 AM MDT

7:00 AM PDT

Please join my meeting from your computer, tablet or smartphone.

https://global.gotomeeting.com/join/110069813

You can also dial in using your phone.

United States : +1 (408) 650-3123

Access Code: 110-069-813

First GoToMeeting? Try a test session: http://help.citrix.com/getready

164

R2 Refinement Phase Background Information Email

Membership Job Task Analysis - Clinical Pathology

1165

R3 Refinement Phase Questionnaire

Strongly agree Agree Disagree Strongly disagree

TASK 1 Identify,describe and interpretmicroscopicabnormalities in blood,bone marrow, bodyfluids, and tissues(cytology and histology)from domestic andnondomestic animals~30%

TASK 2 Recognize andinterpret static visual testresults pertinent toveterinary clinicalpathology ~15%

TASK 3 Interpret andcommunicateclinicopathologic datafrom domestic and non-domestic animals ~25%

TASK 4 Apply theprinciples of commonlyused laboratoryinstrumentation andmethods ~15%

TASK 5 Applyknowledge of thepathophysiology anddiagnosis of disease,with emphasis onmanifestation inlaboratory test data ofanimals ~15%

If you chose "strongly" disagree, please elaborate.

2. Do you agree with the proposed proportion of tasks on the phase II examination?

2166


Comment

3. Are there critical tasks for entry level clinical pathologists omitted in this Job Task Analysis? If yes,indicate.

Yes

No

4. What proportion of microscopy in your job as a Clinical Pathologist consists of interpretation of histologyspecimens (as opposed to cytology)?

0%

1-10%

11-25%

26-50%

51-100%

5. What proportion of microscopic interpretations in your job as a Clinical Pathologist utilize digital slides (asopposed to glass slides)?

0%

1-10%

11-25%

26-50%

51-100%

6. Do you have any concerns/suggestions for the Certifying Examination Board related to the JTA?

3167


7. What is your employment sector?

Academia

Diagnostic Laboratory

Government

Industry

Other (zoo, conservation, consulting, etc.)

8. When did you become certified in Veterinary Clinical Pathology?

2010-2015

1995-2009

1994 or earlier

4168


Q1 Rate the extent to which an entry-levelveterinary clinical pathologist should be

able to perform a taskAnswered: 14 Skipped: 0

0.00%0

0.00%0

100.00%14 14 3.00

0.00%0

21.43%3

78.57%11 14 2.79

0.00%0

0.00%0

100.00%14 14 3.00

0.00%0

14.29%2

85.71%12 14 2.86

0.00%0

7.14%1

92.86%13 14 2.93

0.00%0

0.00%0

100.00%14 14 3.00

7.14%1

21.43%3

71.43%10 14 2.64

# Comment Date

1 Overall, I think in the point distribution and bit less emphasis on description and a bit more on interpretation would be amove in the right direction.

9/7/2016 9:49 PM

2 Not sure why Task 7 is considered non-testable. Parts of QA/QC are noted in other tasks (e.g., Task 4). 8/28/2016 8:52 PM

TASK 1Identify,...

TASK 2Recognize an...

TASK 3Interpret an...

TASK 4 Knowthe principl...

TASK 5 Knowpathophysiol...

TASK 6Non-testable...


0 1 2 3 4 5 6 7 8 9 10

Notessential

Moderatelyessential

Essential Total WeightedAverage

TASK 1 Identify, describe and interpret microscopic abnormalities in blood, bone marrow, bodyfluids, and tissues (cytology and histology) from domestic and non-domestic animals

TASK 2 Recognize and interpret static visual test results pertinent to veterinary clinical pathology

TASK 3 Interpret and communicate clinicopathologic data from domestic and non-domesticanimals

TASK 4 Know the principles of commonly used laboratory instrumentation and methods.

TASK 5 Know pathophysiology and diagnosis of disease, with emphasis on manifestation inlaboratory test data.

TASK 6 Non-testable activities: Compose and communicate interpretation and significance ofresults

TASK 7 Non-testable activities: Know and Understand Quality Assurance

1 / 17 169

R4 Refinement Phase Survey Results

3 In a broad sense, I found it challenging to consider any of these Tasks as anything but essential - it would perhaps beeasier for me to judge whether particular/specific topics that fall within these Tasks are essential or non-essential. (Asa side note, could a term such as "Important, but not essential" perhaps replace "moderately essential," as the latter isa bit hard to qualify. Or, perhaps only two categories are needed?) Also, how much overlap is allowed between/amongTasks? For example, Task 7 seems as though it could be included in Task 4. Related to this, I am not sure how Task7, as written, is not testable? In regards to Task 2, I am not convinced that electron micrographs are "essential"although the overall Task certainly is.

8/22/2016 1:52 PM

4 It seems like tasks 3 and 1 have a lot of overlap with task 5. It will be hard to interpretate clin path data withoutunderstanding of the pathophys. Maybe incorporate task 5 into task 3 and task 1, and increase the relativepercentages given to tasks 3 & 1.

8/22/2016 11:08 AM

5 I wrote moderately essential for task 2. While I think it is important for all clinical pathologists to interpret thesignificance of visual tests and to recognize some more routine images (special stains, QC data), I think asking imageQs on some - like a PARR gel or a microtiter plate reaction - is too specific for an entry level clinical pathologist. Thosethat work/research in these specific areas (like running PCR gels) will know those images but not necessarily thegeneral candidate. Would be careful to scrutinize this section to be sure images asked about are not too esoteric.

8/8/2016 1:47 PM

2 / 17 170


Q2 Do you agree with the proposedproportion of tasks on the phase II

examination?Answered: 14 Skipped: 0

85.71%12

14.29%2 14 1.86

85.71%12

14.29%2 14 1.86

78.57%11

21.43%3 14 1.79

64.29%9

35.71%5 14 1.64

64.29%9

35.71%5 14 1.64

# Comment Date

1 I have no concerns over the general distribution, but I have a question regarding task 5. If the bulk of the phase 1exam emphasizes laboratory test data, this seems to shift the focus of the general pathology portion away from basicdisease pathogensis (this is an area I think we actually need to stress a bit more and try - although I completelyunderstand how difficult this is- to move away from residents simply memorizing receptors and cytokines.)

9/7/2016 9:49 PM

2 I may allocate 20% to TASK5 and 10% to TASK 4. 8/29/2016 4:52 PM

3 Task 1: 35%; Task 2: 10%; Task 3: 35%; Task 4: 10%; Task 5: It's not clear to me how this would be approached toavoid overlap with some of the other sections.

8/22/2016 11:08 AM

4 I think greater understanding of pathophysiology is more important than knowledge of methodology and interpretationof static tests for a regular diagnostic setting. Learning methodology is easier to do on your own that learningpathophysiology (IMO). However, I don't feel very strongly about it.

8/9/2016 3:21 PM

5 Task 4 should include method validation principles 8/9/2016 3:20 PM

TASK 1Identify,...



TASK 4 Knowthe principl...

TASK 5 Knowpathophysiol...

0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 2

Yes No Total WeightedAverage

TASK 1 Identify, describe and interpret microscopic abnormalities in blood, bone marrow, body fluids, and tissues(cytology and histology) from domestic and non-domestic animals ~30%

TASK 2 Recognize and interpret static visual test results pertinent to veterinary clinical pathology ~15%

TASK 3 Interpret and communicate clinicopathologic data from domestic and non-domestic animals ~25%

TASK 4 Know the principles of commonly used laboratory instrumentation and methods ~15%

TASK 5 Know pathophysiology and diagnosis of disease, with emphasis on manifestation in laboratory test data~15%

3 / 17 171


6 This proportion, with greatest emphasis on microscopic abnormalities, is skewed toward a diagnostic laboratoryposition. Given the large number of pharma and academic research positions, the proportion should at least be evenlyweighted toward these roles.

8/9/2016 2:48 PM

7 Recommend increasing the proportion for Task 5 to ~20% and reducing Task 4 to ~10% 8/9/2016 2:45 PM

8 I think these proportions look very fair - would only recommend 1 change - drop task 2 to ~10 % & make task 3 ~30 %.If task 2 has too high a percentage, the quest for images may mandate including some esoteric images than is fair. Ithink data interpretation is very important and deserves more %.

8/8/2016 1:47 PM

4 / 17 172


42.86% 6

57.14% 8

Q3 Are there critical tasks for entry levelclinical pathologists omitted in this Job

Task Analysis? If yes, indicate.Answered: 14 Skipped: 0

Total 14

# Comment Date

1 Task 2, perhaps add serum protein electrophoresis. Task 3, add interpretation of study data/multiple animals in a dataset. Task 4, add method validation. Task 5, cell based causes where applicable?

9/7/2016 9:49 PM

2 Not sure it is critical, but recognizing prenanalytical effects/artifacts of laboratory assays/data is important. It may bepart of TASK 4?

8/29/2016 4:52 PM

3 Actually just a maybe. Laboratory management is required of the clinical pathologist by some companies that onlyhave one clinical pathologist (so sometimes necessary at the entry level). This could be combined withTask 7.

8/28/2016 8:52 PM

4 Overall, the Tasks adequately cover major broad topics. 8/22/2016 1:52 PM

5 There are probably myriad tasks and skills that are not listed but I don't think they should necessarily be expected ofan "entry level" clinical pathologist. I suspect some may comment that the percentage breakdown for tasks in Q2 doesnot entirely reflect breakdown of tasks/competencies specific to certain jobs or sectors of the profession. But germaneto the goal of JTA the proportions outlined seem perfectly reasonable when we consider expectations for newlyminted diplomates, and would provide guidance for a base level of competency that could eventually be supplementedby on-the-job training or additional coursework, if needed.

8/11/2016 9:47 AM

6 I think verbal communication skills are important but can't be tested in this format. Also, there is no requirement forunderstanding their "client", usually a clinician. This may not be appropriate for this commentary, but residenciesshould require some understanding of the realities of being a clinician (and the impact their suggestions have onclinicians, owners and pets) by requiring at least 6 months of clinical practice. If I ran a residency program (anatomicor clinical), I wouldn't admit those without at least a year's experience. What about experience in sample collection?Shouldn't a clinical pathologist be able to explain to a clinician how to collect the best sample and best ways toprocess it prior to submission? They may not have an opportunity after their residency to acquire that knowledge.

8/9/2016 3:21 PM

7 Validation principles 8/9/2016 3:20 PM

8 I think basic principles of method validation should be an essential task. Maybe this is covered in Task 4 but I don'tsee it as it is currently listed. This is especally important in industry.

8/8/2016 5:42 PM

9 I think that all areas are covered very well. 8/8/2016 1:47 PM

Yes

No

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Answer Choices Responses

Yes

No

5 / 17 173


Q4 Do you agree with the proposed speciesdistribution for the Phase II examination?

Answered: 13 Skipped: 1

84.62%11

15.38%2 13 1.85

53.85%7

46.15%6 13 1.54

92.31%12

7.69%1 13 1.92

# Comment Date

1 Lab animal should never be 24% of the exam - almost a 1/4 is too much. 8/22/2016 11:08 AM

2 While I agree that knowledge and experience in laboratory animals is important to pathology training, an upperpercentage of 24% seems high given typical training at academic institutions associated with veterinary teachinghospitals. I think a high percentage of 15% would be more realistic.

8/20/2016 5:28 PM

3 I agree with the species distribution if the lab animal component is toward the lower end of the percentage range. Ithink it is excessive to have 24% lab animal and 10% non-domestic so that approximately 1/3 of the material is fromthese other species. A test comprised of approximately 1/3 material outside domestic realm would likely have to askmore detailed questions of those non-traditional species than is necessary for an entry level pathologist.

8/10/2016 11:12 AM

4 I would likely equalize lab animal and non-domestic personally. I think 24% lab animal is high. 8/9/2016 3:21 PM

5 Although I am biased coming from a toxicologic pathology environment, I feel the tox path/lab animal sector is growingrapidly and that the low end of the lab animal range (12%) is too low. A range of 18-25% feels better to me...giving alower % for wildlife/zoo which I feel is probably not a growth sector with relatively limited job opportunities.

8/9/2016 3:20 PM

6 See comments for question #2 above. 8/9/2016 2:48 PM

7 Some clinical pathologists work in industry or other settings using laboratory animals, but I think the upper limit of 24% for lab animals is far too high. Would keep it to ~10-15 % maximum and put the rest into regular domestic animals ifyou want to reflect species many working clinical pathologists see. .

8/8/2016 1:47 PM

Domestic 70-80%

Lab animal12-24%

Non-domestic(zoo, wildli...

0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 2

Yes No Total Weighted Average

Domestic 70-80%

Lab animal 12-24%

Non-domestic (zoo, wildlife, etc.) 5-10%

6 / 17 174


Q5 Do you agree with the proposeddistribution by organ system for the Phase

II examination?Answered: 14 Skipped: 0

92.86%13

7.14%1 14 1.93

92.86%13

7.14%1 14 1.93

Hemolymphatic20-25%

Skin/Integument5-10%

Cardiovascular2-6%

Gastrointestinal 5-10%

Pancreas,exocrine 2-6%

Liver 5-10%

Endocrine 5-10%

Renal 5-10%

Respiratory2-6%

Nervous/Specialsenses 2-6%

Musculoskeletal2-6%

Reproductive2-6%

Multiorgan/Systemic/Other 2-6%

Non-organbased 10-20%

0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 2


Hemolymphatic 20-25%

Skin/Integument 5-10%

7 / 17 175


92.86%13

7.14%1 14 1.93

85.71%12

14.29%2 14 1.86

92.86%13

7.14%1 14 1.93

85.71%12

14.29%2 14 1.86

92.86%13

7.14%1 14 1.93

78.57%11

21.43%3 14 1.79

85.71%12

14.29%2 14 1.86

85.71%12

14.29%2 14 1.86

100.00%14

0.00%0 14 2.00

92.86%13

7.14%1 14 1.93

85.71%12

14.29%2 14 1.86

92.86%13

7.14%1 14 1.93

# Comment Date

1 Is urininary tract included as part of either renal and/or repro? Could be other as well- but if UAs and cytologicalsamples are included that could be a 2-6% category. If multiorgan includes metabolic diseases (these may overlapwith endocrine) I think that could be a bit higher. I am not sure where coagulopathies are falling (I would put them inthis category as well and then uptick the percentage)

9/7/2016 9:49 PM

2 Might up renal and lower nervous a bit. 8/29/2016 4:52 PM

3 Would it be possible to get more clarification as to what falls into "non-organ" based versus"multiorgan/systemic/other"?

8/22/2016 1:52 PM

4 I agree wtih the general percentages but would prefer the lower end on special senses/nervous, reproductive andmuskuloskeletal. In my experience, those samples aren't seen as commonly as the others. Someone fresh out shouldreally have the common things down and can probably become more familiar with the rarer things once they are out -depending on what their job entails.

8/22/2016 11:08 AM

5 Generally I agree with the proposed distribution. I suggest only minor changes in percentages based on the types ofchemistry cases and cytologic specimens I see and discuss with residents and DVM students in an academic setting.I suggest the higher range of percentages for renal, endocrine, and liver; increase pancreas to 5-10% and reduce GITto 2-6%; lower percentage range for respiratory; at least the higher range for multiorgan to emphasize the integrationof systems (primary and secondary effects of disease).

8/20/2016 5:28 PM

6 GI percentage seems high and respiratory seems low. 8/10/2016 11:12 AM

7 I think endocrine should be much higher, definitely higher than GI. Clinical pathologists get a lot of questions aboutendocrine testing and this should be reflected in the organ system distribution. So much laboratory specialty testing isendocrine diseases.

8/9/2016 3:21 PM

8 The items hemolymphatic, liver, and renal Ive listed as "no" in my mind are the areas where clinical pathologyassessment is a "relative" strength or value for the discipline. I feel at least for liver and renal, these ranges should beincreased, possibly diminishing areas like neuro (little to no clin path value) or non-organ based (up to 20% seemshigh).

8/9/2016 3:20 PM

9 Propose increasing the distribution of liver and renal to ~15-20%. In drug development, these are most commonlyinvolved/affected organs with respect to drug metabolism and excretion.

8/9/2016 2:45 PM

Cardiovascular 2-6%

Gastrointestinal 5-10%

Pancreas, exocrine 2-6%

Liver 5-10%

Endocrine 5-10%

Renal 5-10%

Respiratory 2-6%

Nervous/Special senses 2-6%

Musculoskeletal 2-6%

Reproductive 2-6%

Multiorgan/Systemic/Other 2-6%

Non-organ based 10-20%

8 / 17 176


10 Looks good but recommend increasing skin/integument & dropping cardiovascular a bit - CPs deal with a lot more skindiseases (especially tumor cytology) than cardiovascular. Could also drop reproductive a bit - at my college, we haveminimal theriogenolgy work (we only interpret canine progesterone concentrations and may see 1 vaginal cytolgogy ayear) - the theriogenologists do all the rest.

8/8/2016 1:47 PM

9 / 17 177


Q6 Do you agree with the proposeddistribution of test items by topic for the

phase I and phase II examination?Answered: 14 Skipped: 0

71.43%10

28.57%4 14 1.71

78.57%11

21.43%3 14 1.79

85.71%12

14.29%2 14 1.86

85.71%12

14.29%2 14 1.86

78.57%11

21.43%3 14 1.79

85.71%12

14.29%2 14 1.86

76.92%10

23.08%3 13 1.77

# Comment Date

1 This question combines phase 1 and phase 2, but I will answer relative to the breakdown listed in the JTA documentthat was sent out (slightly different numbers for the two phases). I would like to see more of C5 and C7 in phase 2. Ithink genetic diseases should be hit a bit harder in phase 1 and less so in phase 2 (but this depends a bit on how thegroup is viewing the genetic questions- eg if it is simple recall of what gene/protein is involved vs something akin toexplaining the hemoglobin curve shifts in PFK. I guess questions could fall under multiple categories as well?)

9/7/2016 9:49 PM

2 What happened to toxicities? 8/28/2016 8:52 PM

Genetic 5-10%

Disturbance ofgrowth/neopl...

Cellaging/degene...

Infection/immunity/inflamma...

Metabolic/Nutritional/Defic...

Hemodynamic/Vascular diseas...

Lab Analysis3-5%

0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 2


Genetic 5-10%

Disturbance of growth/neoplasia 15-25%

Cell aging/degeneration/injury/death 5-10%

Infection/immunity/inflammation 40-60%

Metabolic/Nutritional/Deficiency 3-5%

Hemodynamic/Vascular disease 5-10%

Lab Analysis 3-5%

10 / 17 178


3 This looks to be combined values from the JTA document. I think for phase I: genetic 3-5%, dist growth/neoplasia 20-30%, cell aging/injury/etc 10-15%, infection/etc 40-50%, metabolic/nutritional ok, hemodynamic 10-15%, lab analysisok. For phase II: genetic 5-10% is ok, growth/neoplasia 30-40, cell aging/degeneration 5-10% is ok, infection/etc 40-50%, metabolic/etc 5-10%, hemodynamic/vasc disease 10-20%, lab analysis 5-10%.

8/22/2016 11:08 AM

4 I think lab analysis (up to 5-15%) has to be higher because this is the particular domain of a clinical pathologist asthey integrate and bring particular perspective during interactions with clinicians and anatomic pathologists. Reducepercentage applied to infection/immunity/inmflammation to make up the difference. Certainly questions relevant toneoplasia and infection may also be relevant to laboratory analysis.

8/20/2016 5:28 PM

5 Where would endocrine and hormonal disturbances fall on this list? Metabolic? In that case that category needs to beincreased.

8/9/2016 3:21 PM

6 Do not understand the rationale for the majority of test items to be focused on infection/immunity/inflammation. 8/9/2016 2:48 PM

7 I don't know what "lab analysis" means in this context (?) so had trouble deciding if it was worth 3-5 %. Wouldconsider increasing the neoplasia % a bit and dropping genetic down if we are reflecting what diagnostic clinicalpathologists see. The rest of the proportions look fine.

8/8/2016 1:47 PM

11 / 17 179


84.62% 11

7.69% 1

0.00% 0

7.69% 1

Q7 What proportion of microscopy in yourjob as a Clinical Pathologist consists of

interpretation of histology specimens (asopposed to cytology)?


Total 13

0 - 10%

11-25%

26-50%

51-100%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


0 - 10%

11-25%

26-50%

51-100%

12 / 17 180


85.71% 12

7.14% 1

7.14% 1

0.00% 0

Q8 What proportion of microscopicinterpretations in your job as a Clinical

Pathologist utilize digital slides (as opposedto glass slides)?


Total 14

0-10%

11-25%

26-50%

51-100%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


0-10%

11-25%

26-50%

51-100%

13 / 17 181


Q9 Do you have any concerns/suggestionsfor the Certifying Examination Board related

to the JTA?Answered: 11 Skipped: 3

# Responses Date

1 Despite the limited requirement for histopathological evaluations in my day to day job (limited to bone marrow biopsiesand the histopath samples we look at for follow-up purposes), having the extensive exposure I had as a resident Ireally think made me a better pathologist and I fear reducing this component of the exam would remove a majorimpetus for training programs and residents to be sure adequate exposure and experience with histopathology is partof the residency. I also don't know how this becomes a testable item- but somehow incorporating critical review ofliterature/primary data would be fantastic. Maybe scenarios with a glaring statistical or analytical error, omission of acontrol? Not overly nitty gritty- just can they identify a fatal flaw and not take that data/conclusion to the bank type stuff.

9/7/2016 9:49 PM

2 no 8/29/2016 4:52 PM

3 As mentioned, not sure why Task 7 isn't testable, but I would understand that laboratory management basics wouldnot be testable. There appears to be some unavoidable overlap in tasks. Or perhaps it's just difficult differentiatingthem in short descriptions. But it would be difficult for me to map some questions given the current language. Havingsaid that, I'm impressed with the work and grateful that this process is moving forward.

8/28/2016 8:52 PM

4 I would be interested in serving as a "test subject" or otherwise reviewing versions of the Phase I and Phase IIexamination.

8/22/2016 1:52 PM

5 I think keeping some non-marrow histology slides on the exam is important. 8/22/2016 11:08 AM

6 The term "biostatistics" is vague. I actually don't know what you mean by that.Do you mean precision vs. accuracy? 8/9/2016 3:21 PM

7 no 8/9/2016 3:20 PM

8 None 8/9/2016 2:48 PM

9 Opted out to answer Q7 because I might be an outlier. My job is heavily based as an anatomic pathologist readinghistology specimen.

8/9/2016 2:45 PM

10 None other than the suggestion above about testing for assessing principles of method validation 8/8/2016 5:42 PM

11 No strong concerns - it looks like a lot of thought has gone into this and I am very pleased with the new changes tothe certifying examination! The only thing I would urge is to not have the job task section percentages be overlycontrolling. For example, it would not be optimal if one had to include unusual or esoteric images or questions to meeta certain section quota. Therefore, I like the range of percentages (as noted here) for sections rather than a strictpercentage - that allows flexibility and is wise.

8/8/2016 1:47 PM

14 / 17 182


35.71% 5

14.29% 2

7.14% 1

42.86% 6

0.00% 0

Q10 What is your employment sector?Answered: 14 Skipped: 0

Total 14

Academia

DiagnosticLaboratory

Government

Industry

Other (zoo,conservation...

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Academia


Government

Industry


15 / 17 183


28.57% 4

42.86% 6

28.57% 4

Q11 When did you become certified inVeterinary Clinical Pathology?


Total 14

2010-2015

1995-2009

1994 or earlier

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


2010-2015

1995-2009

1994 or earlier

16 / 17 184


Q12 What is your name?Answered: 14 Skipped: 0

# Responses Date

1 Erica Behling-Kelly Happy to expand, provide more detail is anything is unclear. Thank you for your efforts in this. 9/7/2016 9:49 PM

2 Denise Bounous 8/29/2016 4:52 PM

3 Bob Hall 8/28/2016 8:52 PM

4 Kelly S. Santangelo 8/22/2016 1:52 PM

5 Jennifer Scruggs 8/22/2016 11:08 AM

6 Kristen Friedrichs 8/20/2016 5:28 PM

7 Emmeline Tan 8/11/2016 9:47 AM

8 Bridget Garner 8/10/2016 11:12 AM

9 Paula Krimer 8/9/2016 3:21 PM

10 Adam Aulbach 8/9/2016 3:20 PM

11 Nathaniel Collins 8/9/2016 2:48 PM

12 Aradhana Gupta DVM, MVSc, DACVP (Anatomic and Clinical Pathology), DABT 8/9/2016 2:45 PM

13 William J. Reagan 8/8/2016 5:42 PM

14 Shelley Burton 8/8/2016 1:47 PM

17 / 17 185


TASKANDBLUEPRINTLISTSANDCONTENTPERCENTAGESFORCLINICALPATHOLOGY


• Testedviaglassslidesandimage-basedMCQs• ~30%ofPhaseII

Skillsandknowledgeto:• Writeacoherent,organizeddescriptivereport• Summarizerelativetothedescriptivefindings• Interpretiveconclusion(s)and/ordiagnosis(es)• Listappropriatedisease,condition,and/ordifferentialdiagnoses• Listpotentialcauses(s)• Describeassociatedchangesinotherorgan• Outlineappropriateancillarytestsandanticipatedresults(e.g.specialstains,



• Testedviaimage-basedMCQs• ~10%ofthePhaseII

Skillsandknowledgeforinterpretationof:• Hematologycytograms• Flowcytometryplots• Coagulationtracings• Plateletaggregationplots• Macroscopichematologytestresults(eg.Coombstests)• Specialandimmunochemicalstains• Electronmicrographs• Qualityassuranceandqualitycontroldata.• PCRclonalityresults


• TestedviacaseessaysandMCQs• ~30%oftheentirePhaseIIexam.

Skillsandknowledgeto:• Describepathophysiologyofconditionsleadingtolaboratoryabnormalities• Integratelaboratoryabnormalitiesintoadiagnosis(ordifferentialdiagnoses)• Knowappropriateancillaryteststofurtherconfirmdefinitiveordifferential

diagnoses

186

R5 Modified Task and Blueprint Document

• Interpretpopulationlaboratorydataorstudysetdata• Interpretintegratedlaboratoryresults(biochemistry,urinalysis,serology,

microbiology,serumproteinelectrophoresis,immunodiagnostics,coagulation,hematology,etc.)

TASK4:Applytheprinciplesofcommonlyusedlaboratoryinstrumentationandmethods


Usingknowledgeof: • Analyzerandtestproceduremethodologies• Sampletypesandcollectionmethods• Referenceintervaldetermination• Errorsandinterferences(pre-analytical,analyticandpost-analytical)• Testproperties(sensitivity,specificity,predictivevalues,ROC,etc.)andselection• Qualitycontrol,qualityassurance,relevantstatistics• Referenceintervalandmethodvalidationprinciples,relevantstatistics• Routine,specialandimmunochemicalstains • Microscopeprinciples,• Laboratorysafety,biosafety



Usingknowledgeof:Pathogenesis,etiologyandorgan-basedcausesforthefollowingdiseaseprocesses

• Genetic • Disturbanceofgrowth/neoplasia • Cellaging/degeneration/injury/death • Infection/immunity/inflammation • Metabolic/Nutritional/Deficiency • Hemodynamic/Vasculardisease


• Testedvianon-imagebasedMCQs• 100%ifPhase1(SeePhaseITopicDistributionbelow)


o Cellularinjuryo Inflammationandrepairo Hemodynamicdisorderso Physicalandchemicalinjuryo Neoplasia

187


o Congenitalandgeneticdiseaseso Molecularpathologyo Infectiousprocesseso Immunology





TASK8DemonstrateProficiencyinLaboratoryManagementandResultsReleaseQualityPractices




• DemonstrateoveralllaboratorymanagementaptitudePhaseIIBlueprintCategoryTargetsDistributionbySpecies(PhaseII)S1Domestic 70–85% S2Labanimal 10–15% S3Non-domestic 5–10% DistributionbyOrgansystem(PhaseII) O1Hemolymphatic,includingcoagulation 20–25% O2Skin/Integument 6–12%O3Cardiovascular 2–4%O3Gastrointestinal 2–6%O4Pancreas,exocrine 2–6%05Liver 12–15%O6Endocrine 8–12%

188


O7Renal,includingurinalysisandurinarytract 15–20%O8Respiratory 2–6%O9Nervousandspecialsenses 2–4%O10Musculoskeletal 2–6%O11Reproductive 2–4%O12Non-organbased* 10–20%*Definedasmostlyprinciplesoflaboratorytechnology,fromselecteditemsinTasks2and4.

Distributionbytopic(PhaseII) C1Genetic 5–10%C2Disturbanceofgrowth/NEOPLASIA 20–30%C3Cellaging/degeneration/injury/death ~5% C4Infection/immunity/inflammation 25–35% C5Metabolic/includingendocrinopathy,acidbase,10–15%abnormalbiochemistry C6Hemodynamic/Vasculardisease ~5%C7LaboratoryTechnology 15–20% PhaseI(GeneralPathologyBlueprint)Distributionbytopic(PhaseIExaminationtargets,sameforbothAnatomicalandClinicalPathology)C1Genetic 5–10%C2Disturbanceofgrowth/neoplasia 15–25%C3Cellaging/degeneration/injury/death 5–15%C4Infection/immunity/inflammation35–55%C5Metabolic/Nutritional/Deficiency5–10%C6Hemodynamic/Vasculardisease 5–10%C7LaboratoryTechnology 3–5%

189


ACVPNewsletter•September2016JobTaskAnalysisSurveyCominginLateSeptemberInlateSeptember,alldiplomateswillreceiveanemailrequesttocompleteashortonlinesurvey.ThissurveyispartoftheCollege’songoingJobTaskAnalysis(JTA)insupportoftheCertifyingExaminationsinAnatomicandClinicalPathology.Youwillbeaskedtoevaluatetheappropriatenessofkeyhighleveltasksrequiredofanentrylevel/minimallycompetentveterinaryanatomicand/orclinicalpathologist.ThesedrafttasksweregeneratedbypanelsofdiplomatesearlierintheJTAprocess.Thesurveyshouldnottakemorethan10minutestocomplete,andwehopethatalldiplomateswillparticipateinthisimportantactivity,asdataderivedfromtheJTAwillbeusedtodevelopcontentforourcertifyingexaminations.ProvidedbelowisbackgroundinformationregardingtheJobTaskAnalysisprocess.BackgroundTheAmericanBoardofVeterinarySpecialties(ABVS)requiresthateachconstituentspecialtycollegeorboardconductaJob/TaskAnalysis(JTA)atleastevery10years.TheABVSdefinesaJob/TaskAnalysisasfollows:Job/TaskAnalysis—Asystematicprocedurefordefiningthetasksrequiredbyajobandtheknowledge,skills,abilities,andotherpersonalcharacteristicsrequiredofindividualsperformingthatjob.Theresultsofajob/taskanalysisformthebasisfordeterminingtheexaminationcontentsnecessarytotestmasteryofthatfield.TheACVPconductedaRoleDelineationStudy(RDS)in2007-2008,facilitatedbyDr.JimHendersonofCastleWorldwide.Resultsofthisstudywerepublishedin2009.Atestplanortestitem“blueprint”wasdevelopedbasedonthatstudy,andtheExaminationCommittee(EC)mappedtestitemstothetestplanbeginningin2010.SuccessiveECshaverevisedthetestplantomoreaccuratelyreflectexamcontent,whilestilladheringtotheresultsoftheRDS.TheCertifyingExaminationBoard(CEB)wasformedin2011andreviewsthetestplanannually.In2012,thetestplanwasevaluatedindepthandmodifiedbyasubcommitteeoftheCEBwiththesupportofDr.HendersonandinputfromtheExaminationCommittee.TheCollege’ssubsequentdecisionin2015toredesignthePhaseIICE,withimplementationin2017,promptedtheneedtoconductanewRDS.TheCEBelectedtousetheterminology“Job/TaskAnalysis(JTA)”ratherthanRDSgoingforward,astheformerisconsistentwiththeterminologyusedbytheABVS.In2015,theCEB,inpreparationforconductingtheJTAandbuildingonthedataandconclusionsderivedfromthe2009RDS,developeddraft“keytasks”performedbyentry-levelveterinarypathologistsengagedinbothspecialties.InMarch2016,theCEBdraftedadocumentoutliningtheJTAprocess,withanobjectiveofcompletingthistaskandgeneratingablueprintforthe2017PhaseIICEandthe2018PhaseIexaminationbythe2016AnnualMeeting.AlthoughaJob/TaskAnalysisisabestpracticeforhighstakescertifyingexaminations,thereisnosinglemethodrecommendedforconductingthisanalysis(NationalCommissionforCertifyingAgenciesStandardsfortheAccreditationofCertifyingPrograms,Standard10).TheCEB,withapprovalofACVPCouncil,electedtoconductaJTA,buildingonthedatacollectedfromthe2007-2008RDS,theexperiencegainedbytheECandtheCEBoverthelastsevenyearsworkingwiththetestplanbasedonthatstudy,draftkeytasksdevelopedbytheCEB,andthecurrentCEtestplanmatrix.TheCEBalsorecognizedthatthecompositionofthecurrentexamination,developedannuallyforoverfivedecadesbygenerationsofExaminationCommitteemembersrepresentativeoftheCollegeatlarge,representsvaluablehistoricaldatarelativetoCEcontent.ThephasesofJTAareasfollows:1.Invention(complete).ThisphasewasconductedbytheextendedCEB,whichiscomposedof11coremembersappointedbyCouncilandnineadhocmembersrepresentinganumberofACVPcommittees,includingtheExamination,TrainingProgram,andCredentialingcommittees.Theobjectiveofthisphasewastoconfirmandrefine“keytasks”performedbyentry-levelveterinarypathologistsengagedinbothspecialtiesforsubsequentlevelsofbroaderreview.AlsoincludedinthisstageoftheprocessweredraftCEtestitempercentagesforeachofthetestableTasksandfor“Blueprint”categoriesofspecies,organ

190

V1 ACVP Newsletter JTA Description

system,andprocess/topic.2.Refinement(inprocess).Inthisphase,twopanels,oneforanatomicpathology(20members)andoneforclinicalpathology(15members),representingkeydemographicsoftheCollege,wereaskedtoreviewthedrafttasksandblueprintcategories,andprovidefeedbacktotheCEBforrefinementconsideration.3.Validation(lateSeptember/October2016).Inthisphase,theACVPmembershipwillhavebeenaskedtoparticipateinasurveyaskingfora1-3levelagreementoneachitemoftheJTA.Memberswillalsobeaskedtoprovidereasonsfordisagreements.Followingitsreviewofthemembershipsurveyresults,theCEBwillfurtherrefinetheJTA.4.Approval.ThefinaldocumentwillbesubmittedtoCouncilforapproval.Followingapproval,theECwillusetheBlueprintsectionoftheJTAforCEdevelopmentandmapping.11ACVPNews

191

V1 ACVP Newsletter JTA Description

Dear ACVP Diplomate,

Maintaining the excellence of ACVP certification necessitates that the College periodically perform a job task analysis (JTA) through surveying its members. This process helps document what certified veterinary pathologists do in their work, and supports the Certifying Examinations in Anatomic and Clinical Pathology. Results of the JTA help validate key tasks required of entry level/minimally competent pathologists. Key tasks were drafted by a twenty member “Invention Committee” of ACVP members, and were refined following input from 20 member anatomic pathology and 14 member clinical pathology “Refinement Committees”. More detailed information regarding this process is available in the September 2016 Newsletter: http://www.acvp.org/Newsletters/2016_ACVP_September_Newsletter_WEB.pdf .

Your input as a member of the College is a critical part of the JTA process. Please select the appropriate link below to complete either the clinical pathology survey or the anatomic pathology survey. Dual boarded pathologists may take both surveys, or alternatively complete one most relevant to your current area of professional activity.

The JTA survey will take only about 10 - 15 minutes to complete, and your participation will help ensure the prestige of ACVP certification in the future. Survey results will be used to adjust examination content, and to capture other important information about the current state of our profession. A more detailed description of AP and CP tasks are available at:

Link to anatomic pathology survey: https://www.surveymonkey.com/r/KRNH7LN

Link to clinical pathology survey: https://www.surveymonkey.com/r/LQ7NTKG

Thank you for your participation in the JTA survey and your continued support of the ACVP.

Keith Harris on behalf of the members of the ACVP Certifying Examination Board

185 192

V2 Email to ACVP Membership Describing Survey

KEY TASKS PERFORMED BY ENTRY LEVEL/MINIMALLY COMPETENT ANATOMIC PATHOLOGISTS TASK1:Identify,describeandinterpretmicroscopicconditionsindomesticandnon-domesticanimals

• TestedusingglassorvirtualslideessaysandMCQs• ~40%ofPhaseII

Skillsandknowledgeto:• Writeacoherent,organizedhistopathologicdescription• Give a morphologic diagnosis • Give appropriate disease, condition, and/or differential diagnoses • List potential causes(s) • Describe/relate to associated macroscopic and clinicopathologic findings and

changes in other organs • Select appropriate ancillary tests and interpret their results (e.g. special stains,

immunohistochemistry, electron microscopy, PCR-based clonality, flow cytometry, cytology, etc.)

TASK2:Identifyandinterpretmacroscopicconditionsindomesticandnon-domesticanimals

• Testedviaimage-basedMCQs• ~20%ofPhaseII

Skillsandknowledgeto:• Giveamorphologicdiagnosis• Give appropriate disease, condition, or differential diagnoses • List potential cause (s) • Outline a pathogenesis • Relate to clinical information and histologic findings • Describe associated changes in other organs or clinicopathologic findings • Select appropriate ancillary tests and interpret their results (e.g. special stains,

immunohistochemistry, electron microscopy, PCR-based clonality, flow cytometry, cytology, in situ hybridization, etc.)

TASK3:Interpretclinicopathologicdatafromdomesticandnon-domesticanimals

• TestedviaMCQs• ~10%ofthePhaseII

Skillsandknowledgeto:• Recognize the cause (or most likely causes) of laboratory abnormalities • Integrate laboratory abnormalities into a diagnosis (or likely differential diagnoses) • Select appropriate ancillary tests to further refine a diagnosis or differential

diagnoses

193


TASK4:Applyknowledgeofthepathophysiology,progressionanddiagnosisofdiseaseinanimals

• Testedvianon-imagebasedMCQs• ~30%ofthePhaseII

UsingKnowledgeof:• The pathology and pathogenesis of diseases of domestic animals (cattle, sheep,

goat, horse, dog, and cat). • The pathology and pathogenesis of, and prognosis for, common conditions of

nondomestic animals • Newandemergingdiseases• Well-recognized animal models of human disease • Core concepts and current literature • The integration of test results (microscopic, hematologic, biochemical, etc.) and

clinical information TASK5Demonstrateknowledgeoflaboratorytechnology

• Testedvianon-imagebasedMCQs• ~2%ofthePhaseII

Usingknowledgeof:• Principlesofcommonlyusedlaboratorytests• Qualityassuranceandqualitycontrolforlaboratorytests


• Testedvianon-imagebasedMCQs• 100%ifPhase1


o Cellularinjuryo Inflammationandrepairo Hemodynamicdisorderso Physicalandchemicalinjuryo Neoplasiao Congenitalandgeneticdiseaseso Molecularpathologyo Infectiousprocesseso Immunology

• MechanismsaregeneralinnatureinthattheyrelatetomostanimalspeciesNON-TESTABLE TASKS (Currently listed on the CE Sponsor Verification Form) TASK 7: Data Collection, Analysis and Interpretation

• Performnecropsiesandcollectgrossmorphometricdatabyweighingand/ormeasuringtissues,lesions,organs,wholeanimals,andotherspecimensinaccordance

194


withestablishedprotocolsandusingprofessionaljudgmentinordertounderstandpathogenesis,diagnosedisease,and/orperformquantitativedataanalysis.

• Reviewantemortemdataandhistoryusingasystematicprocessinordertosupportthecollectionofrelevantsamples.

• Collectspecimensand/orguideothersinsamplecollectionaccordingtoprotocolsorprofessionaljudgmentforhistology,cytology,andothertestingforsubsequentanalysisorarchivinginordertopreservesampleintegrity.

• Describegrossmorphologicalobservationsusingasystematicapproachandappropriate,medicalterminologyinordertoprovideacompleteandaccuraterecord.

• Integrateindividualanimaldatabycorrelatingclinicalpathology,toxicology,diagnosticimaging,microbiology,andothertestresultswithmorphologyinordertocharacterizethepathogenesisofdiseaseorformulateadiagnosis.

• Identifyartifactsintissuesectionsandothersamplesusingprofessionaljudgmentandexpertiseinordertoidentifythosethatcouldbemisinterpretedorimpedetheabilitytoassessthetissueresponseaccurately.

TASK8:Communicatepathologyfindingsandtheirsignificancethroughclearandconciseoralandwrittenreportstoregulators,clinicians,scientistsandotherstakeholdersinordertoprovideappropriatecontext

195


Membership Job Task Analysis - Clinical Pathology

1196

V3 Validation Phase Questionnaire

Strongly agree Agree Disagree Strongly disagree

TASK 1 Identify,describe and interpretmicroscopicabnormalities in blood,bone marrow, bodyfluids, and tissues(cytology and histology)from domestic andnondomestic animals~30%

TASK 2 Recognize andinterpret static visual testresults pertinent toveterinary clinicalpathology ~15%

TASK 3 Interpret andcommunicateclinicopathologic datafrom domestic and non-domestic animals ~25%

TASK 4 Apply theprinciples of commonlyused laboratoryinstrumentation andmethods ~15%

TASK 5 Applyknowledge of thepathophysiology anddiagnosis of disease,with emphasis onmanifestation inlaboratory test data ofanimals ~15%

If you chose "strongly" disagree, please elaborate.

2. Do you agree with the proposed proportion of tasks on the phase II examination?

2197


Comment

3. Are there critical tasks for entry level clinical pathologists omitted in this Job Task Analysis? If yes,indicate.

Yes

No

4. What proportion of microscopy in your job as a Clinical Pathologist consists of interpretation of histologyspecimens (as opposed to cytology)?

0%

1-10%

11-25%

26-50%

51-100%

5. What proportion of microscopic interpretations in your job as a Clinical Pathologist utilize digital slides (asopposed to glass slides)?

0%

1-10%

11-25%

26-50%

51-100%

6. Do you have any concerns/suggestions for the Certifying Examination Board related to the JTA?

3198


7. What is your employment sector?

Academia


Government

Industry


8. When did you become certified in Veterinary Clinical Pathology?

2010-2015

1995-2009

1994 or earlier

4199


Q1 Rate the extent to which an entry-levelveterinary clinical pathologist should be

able to perform a taskAnswered: 115 Skipped: 0

0.87%1

1.74%2

97.39%112 115 2.97

6.19%7

26.55%30

67.26%76 113 2.61

0.00%0

6.09%7

93.91%108 115 2.94

3.48%4

46.09%53

50.43%58 115 2.47

0.87%1

16.52%19

82.61%95 115 2.82

1.74%2

24.35%28

73.91%85 115 2.72

0.00%0

18.42%21

81.58%93 114 2.82

13.04%15

54.78%63

32.17%37 115 2.19

TASK 1Identify,...



TASK 4 Applythe principl...

TASK 5 Applyknowledge of...

TASK 6Demonstrate...


Task 8Non-testable...

0 1 2 3 4 5 6 7 8 9 10

Notessential

Moderatelyessential

Essential Total WeightedAverage

TASK 1 Identify, describe and interpret microscopic abnormalities in blood, bone marrow, bodyfluids, and tissues (cytology and histology) from domestic and non-domestic animals

TASK 2 Recognize and interpret static visual test results pertinent to veterinary clinical pathology

TASK 3 Interpret and communicate clinicopathologic data from domestic and non-domesticanimals

TASK 4 Apply the principles of commonly used laboratory instrumentation and methods

TASK 5 Apply knowledge of the pathophysiology and diagnosis of disease, with emphasis onmanifestation in laboratory test data of animals

TASK 6 Demonstrate knowledge of the basic mechanisms of disease

TASK 7 Non-testable activity: Compose and communicate interpretation and significance of testresults

Task 8 Non-testable activity: Demonstrate proficiency in laboratory and quality management

1 / 11 200

V4 Validation Phase Survey Results

Q2 Do you agree with the proposedproportion of tasks on the phase II

examination?Answered: 115 Skipped: 0

60.87%70

31.30%36

5.22%6

2.61%3 115 1.50

38.94%44

43.36%49

14.16%16

3.54%4 113 1.82

53.98%61

43.36%49

0.88%1

1.77%2 113 1.50

33.91%39

54.78%63

9.57%11

1.74%2 115 1.79

48.70%56

40.00%46

7.83%9

3.48%4 115 1.66

# If you chose "strongly" disagree, please elaborate. Date

1 This is a large percent of the overall score for something that really tests a candidates ability to memorize picturesfrom key textbooks, Vet clin path and Vet path. Assessing same concepts under Task 1 is much more relevant to reallife and effective in discriminating.

11/1/2016 8:55 AM

2 TASK 1: % should still be higher 10/27/2016 11:08 AM

3 I would put less weight on Task 1 and more weight on Tasks 2 and 5. 10/27/2016 10:20 AM

4 Task of identification, description and interpretation of biochemical abnormalities is missing, which may explain whythis is a significant weakness of American clinical pathologists. Task 2 and 5 are unclear in their language and shouldbe re-written.

10/27/2016 5:46 AM

5 Task 1 needs higher percentage as it is 80% of the required work in the lab. 10/26/2016 11:01 PM

TASK 1Identify,...



TASK 4 Applythe principl...

TASK 5 Applyknowledge of...

0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 2

Stronglyagree

Agree Disagree Stronglydisagree

Total WeightedAverage

TASK 1 Identify, describe and interpret microscopic abnormalities in blood, bone marrow,body fluids, and tissues (cytology and histology) from domestic and nondomestic animals~30%

TASK 2 Recognize and interpret static visual test results pertinent to veterinary clinicalpathology ~15%

TASK 3 Interpret and communicate clinicopathologic data from domestic and non-domestic animals ~25%

TASK 4 Apply the principles of commonly used laboratory instrumentation and methods~15%

TASK 5 Apply knowledge of the pathophysiology and diagnosis of disease, withemphasis on manifestation in laboratory test data of animals ~15%

2 / 11 201


6 Not sure about the "non-domestic" animals language. Leaves a fairly broad range, maybe too broad for entry level.Same for "commonly used laboratory instrumentation."

10/26/2016 6:28 PM

7 As most students leaving a residency program will be entering positions involving interpreting microscopic findings,this should comprise more than 30% of the test, possibly 50%, with lesser amounts devoted to instrumentation (whichwill vary by site and changes frequently) and pathophysiology.

10/21/2016 1:18 PM

8 Lab methods and QC really needs to be emphasized. I think it should be 20% rather than 15% because I find this tobe a bigger part of my job than I was prepared for.

10/19/2016 8:39 AM

9 Interpreting case data sets without history and physical exam findings is artificial and contrary to all recommendationsabout use of data. We should stop testing this way.

10/19/2016 6:28 AM

10 Although I didn't select strongly disagree, I think there should be less for task 4 (bring to 10% or less) and more fortask 1 (should be 40-45%). Honestly though, there is so much overlap between tasks 2, 3, and 5 that I am unsure howthese are truly being delineated and tested in a meaningful way. For that reason and because so many clinicalpathologists go into some diagnostic role, there should be more emphasis on task 1.

10/18/2016 8:36 PM

11 Not sure what task 2 means, so did not respond. Disagree may mean too much or too little. 10/18/2016 5:00 PM

12 It is unclear what static visual test results are: Photomicrographs? There should be more emphasis on interpretationthan description and on pathophysiology of disease and knowledge of disease. If principles is memorization work offormula no-one uses, then I am not in favor of that, but application of how a test method may impact results,absolutely or understanding how to choose the optimal method or trouble shoot a problem, absolutely. Qualityassurance is very important as is thinking about study design - how to set up a reference interval study, methodvalidation, comparative testing.

10/18/2016 4:40 PM

13 My job requires less microscopic and more interpretation of numeric results. Think these should be equal. Task 5 isour bread and butter. If we don't have this, nothing else matters. Should be higher percentage.

10/18/2016 4:13 PM

14 For tasks 1-2 and 4-5, I favor minor changes such as 1-35%, 2-10%, 4-10%, 5-20% 10/18/2016 2:52 PM

15 I do actually disagree with having to interpret histopathology. Most residencies don't focus on this or there is minimaltraining.

10/18/2016 2:46 PM

3 / 11 202


19.64% 22

80.36% 90

Q3 Are there critical tasks for entry levelclinical pathologists omitted in this Job

Task Analysis? If yes, indicate.Answered: 112 Skipped: 3

Total 112

# Comment Date

1 Apply knowledge of additional diagnostic testing opportunities to facilitate cytology and/or chemistry interpretations. 11/9/2016 3:13 PM

2 A major portion of my role in diagnostic clinical pathology is interpreting response to therapy, for example:phenobarbital, trilostane, antithyroidals, thyroid supplementation. While I think that students have enough to learn, andso would not advocate to add them to any curriculum, these are essential parts of my job that I had to learn on the fly.

11/9/2016 1:05 PM

3 Toxicology procedures 11/3/2016 5:00 PM

4 Additional diagnostic tests to run (if applicable). 11/2/2016 12:45 AM

5 I would expand Task 4 so that it clearly includes an understanding of what Quality Assurance and LaboratoryStandards - how they are implemented and managed.

11/1/2016 8:55 AM

6 Communication skills, both with colleagues (pathologists and other veterinarians and medical professionals) andmedical technologists/other laboratory staff personnel, are also essential. But granted, no likely way to test for this.

10/31/2016 5:12 PM

7 Where would understanding and applying basic statistical procedures to clinical pathologic topics be included in theabove categories, eg, ROC curves, sens, spec, PPV, etc.

10/29/2016 2:32 PM

8 Demonstrate/apply some basic quality assurance principles, including essential elements of a quality assuranceprogram in a laboratory. It was unclear if this was included under instrumentation and methods.

10/27/2016 9:26 AM

9 Task of identification, description and interpretation of biochemical abnormalities is missing, which may explain whythis is a weakness of American clinical pathologists. This task needs to be explicitly stated and assessed. Iunderstand that it is thought to be covered by the other tasks, but it is not, at least not sufficient.

10/27/2016 5:46 AM

10 Perform bone marrow aspirates 10/26/2016 11:01 PM

11 do not agree with statement above that quality management is not testable. believe this can be addressed and iscertainly something that distinguishes clinical pathologist from internal medicine wannabes

10/26/2016 6:45 PM

12 Soft skills 10/24/2016 11:35 AM

13 knowledge and application of special stains and additional diagnostic options available 10/21/2016 12:06 PM

Yes

No

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Yes

No

4 / 11 203


14 Ability to critically assess the research literature and apply new knowledge. 10/19/2016 6:13 PM

15 This may be covered in task #5, but it is important to for a CP to be able to advise clients on which is the 'next besttest' in a logical diagnostic algorithm, given the patient's signs and any testing that has already been done--thisrequires knowledge of pathophysiology and abilities/limitations of available tests--should be able to explain therationale of ranked diagnostic choices.

10/19/2016 7:51 AM

16 Be current on most recent recommendations concerning method validation and quality control (including POCTequipment).

10/19/2016 7:33 AM

17 I can't tell for sure, but testing reference interval generation processes, method comparison processes, concepts oftotal error, bias, and precision, and QC testing may not be included adequately. These are nuts and bolts of being aclinical pathologist in many settings.

10/19/2016 6:28 AM

18 As a part of interpretation, it is just as important to communicate the significant information to theclinician/client/staff/student/etc.

10/18/2016 11:34 PM

19 Trouble-shooting unexpected findings in a logical and orderly manner. Effective and productive communication withclinicians. Critical analysis of the literature.

10/18/2016 5:00 PM

20 Interpreting quality assurance data and knowing how to apply it, method validation, method comparison testing, testinglinearity, precision etc, knowledge of basic pathophysiology that are applicable to a case and not just listing everypossibility for a change.

10/18/2016 4:40 PM

21 I no longer believe that QA/QC is non-testable and feel these concepts should be included in the testing process. 10/18/2016 4:05 PM

22 Demonstrate proficiency in laboratory and quality management 10/18/2016 3:30 PM

23 It's hard to determine if this was captured in the questions above but I think entry level clinical pathologists need to beable to evaluate the validity and importance of novel tests.

10/18/2016 3:05 PM

24 In my setting in a private diagnostic lab, the ability to communicate to customers in an appropriate and engaged way isa critical skill. However, I do not think that skill is best evaluated with the board examination. This skill is probably bestevaluated in an interview setting. I am pleased with the scope of the board examination as described.

10/18/2016 2:51 PM

5 / 11 204


47.83% 55

41.74% 48

6.96% 8

1.74% 2

1.74% 2

Q4 What proportion of microscopy in yourjob as a Clinical Pathologist consists of

interpretation of histology specimens (asopposed to cytology)?


Total 115

0%

1-10%

11-25%

26-50%

51-100%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


0%

1-10%

11-25%

26-50%

51-100%

6 / 11 205


68.70% 79

21.74% 25

7.83% 9

0.87% 1

0.87% 1

Q5 What proportion of microscopicinterpretations in your job as a Clinical

Pathologist utilize digital slides (as opposedto glass slides)?


Total 115

0%

1-10%

11-25%

26-50%

51-100%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


0%

1-10%

11-25%

26-50%

51-100%

7 / 11 206


Q6 Do you have any concerns/suggestionsfor the Certifying Examination Board related

to the JTA?Answered: 23 Skipped: 92

# Responses Date

1 None 11/9/2016 3:13 PM

2 No 11/9/2016 1:05 PM

3 If feasible, I think it would be good for the examination to incorporate at least one problem-solving exercise in qualitymanagement - a short essay question that asks "How would you handle this situation?" In the old exam format, I wouldenvision such a question replacing one of the four traditional biochemistry cases, but I'm unsure of the best way tointegrate it with the new exam format. Thanks for considering it. Mike Fry

11/4/2016 8:43 AM

4 Having not seen what is currently offer I can't reply. 11/3/2016 5:00 PM

5 no 10/31/2016 7:51 PM

6 I think that there should be more emphasis placed on pathophysiology in clinical pathology, similar to what isexpected in anatomic pathology.

10/27/2016 11:28 AM

7 When I took the exam, I don't recall having questions on interpreting data as it would be in the tox/pharmaceuticalfield OR having questions Tox oriented. This should/could be included. I believe this SHOULD be included in the3year residency training. I believe most programs are good to become a ''diagnostician'' but exposure /awarness of thetox industry might need to be added.

10/27/2016 11:08 AM

8 Yes, those indicated above. Need for greater transparency eg effective "mock exams" 10/27/2016 5:46 AM

9 no 10/26/2016 11:32 PM

10 not at this time 10/26/2016 6:45 PM

11 No, but in general, I think the exam should include more horses, fewer zebras. Rare and uncommon diagnoses arenot essential at entry level.

10/26/2016 6:28 PM

12 Even though histology is not significant portion of my current job, I feel it is important for the clinical pathologist tounderstand how to approach a histologic section, be able to describe it and recognize common lesions.

10/26/2016 6:17 PM

13 No, I think the efforts put forth on overhauling this examination are long overdue and the format is more realistic andapplicable for trainees. I applaud the change in venue and the change in approach to a more integrating knowledgebased examination.

10/26/2016 4:44 PM

14 It's a huge task to design the exam, and I have a great deal of respect for the Board/Committee. I'd love to help but asa sole proprietor consultant, it's impossible. Thanks!

10/26/2016 4:37 PM

15 no 10/26/2016 4:23 PM

16 As stated above QC, instrumentation, scattergrams all should be emphasized more on the exam. 10/19/2016 8:39 AM

17 The new exam format seems very abridged. Not sure if it is truly a complete measure of overall competency. 10/18/2016 11:34 PM

18 The great deal of overlap between tasks 2, 3, and 5 and how/if these are truly being delineated and tested in ameaningful way. It would seem the proportion, percentage wise, is discordant with the knowledge actually beingtested.

10/18/2016 8:36 PM

19 Question structure in this survey, will result in ambiguous results. 10/18/2016 5:13 PM

20 Yes. Stop asking questions that require memorization of recent literature. This does not encourage or facilitate criticalthinking or journal review. There are SO many poorly designed and flawed studies in the literature that should neverbe used for questions and this encourages applicants to only read the last 3 years of literature and not critically either.Asking questions that integrate knowledge versus test memorization skills of minutae or obscure articles/pet topics.Emphasize points of interpretation versus description. I have heard that candidates have passed the cytology andhematology sections without putting in an interpretation which is plain crazy. Provide research clin path data forevaluation and not just tox studies.

10/18/2016 4:40 PM

8 / 11 207


21 Only concerned that I don't know what JTA stands for or that basic scientific communication conventions were notused in this survey.

10/18/2016 4:00 PM

22 For now, our laboratory does not utilize digital slides, but we are constantly watching the evolution of technology sothat if there are any new breakthroughs, we will utilize them. The board committee should therefore remain alert to anynew opportunities to utilize digital technologies for clinical pathology.

10/18/2016 2:51 PM

23 No 10/18/2016 2:42 PM

9 / 11 208


47.83% 55

37.39% 43

0.87% 1

11.30% 13

2.61% 3

Q7 What is your employment sector?Answered: 115 Skipped: 0

Total 115

Academia

DiagnosticLaboratory

Government

Industry

Other (zoo,conservation...

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Academia


Government

Industry


10 / 11 209


42.61% 49

37.39% 43

20.00% 23

Q8 When did you become certified inVeterinary Clinical Pathology?


Total 115

2010-2015

1995-2009

1994 or earlier

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


2010-2015

1995-2009

1994 or earlier

11 / 11 210


TASKANDBLUEPRINTLISTSANDCONTENTPERCENTAGESFORCLINICALPATHOLOGY


• Testedviaglassslidesandimage-basedmultiplechoicequestions(MCQs)• ~30%ofPhaseII

Skillsandknowledgeto:• Writeacoherent,organizeddescriptivereport• Writeaconcisesummaryrelativetothedescriptivefindings• Writeaninterpretiveconclusion(s)and/ordiagnosis(es)• Listappropriatedisease(s),condition(s),and/ordifferentialdiagnoses• Listpotentialcauses(s)• Describeassociatedchangesinotherorgan(s)• Outlineappropriateancillarytestsandanticipatedresults(e.g.specialstains,



• Hematologycytograms• Flowcytometryplots• Coagulationtracings• Plateletaggregationplots• Macroscopichematologytestresults(eg.Coombstests)• Grossappearanceofsubmittedsamples• Specialandimmunochemicalstains• Electronmicrographs• Qualityassuranceandqualitycontroldata• Proteinelectrophoretogramsandimmunofixationreactions• PCRclonalityresults


• Describepathophysiologyofconditionsleadingtolaboratoryabnormalities• Integratelaboratoryabnormalitiesintoadiagnosis(ordifferentialdiagnoses)

211

X Task and Blueprint Lists

• Tested via image-based MCQs• ~10% of Phase II Skills and knowledge for interpretation of:

• Tested via case essays and MCQs• ~30% of Phase II Skills and knowledge to:

• Recommendappropriateancillaryteststofurtherconfirmdefinitiveor differentialdiagnoses

• Interpretpopulationlaboratorydataorstudysetdata• Interpretintegratedlaboratoryresults(biochemistry,urinalysis,serology,

microbiology,serumproteinelectrophoresis,immunodiagnostics, coagulation,hematology,etc.)

TASK4:Applytheprinciplesofcommonlyusedlaboratoryinstrumentationandmethods• Testedvianon-imagebasedMCQs• ~10%ofPhaseII

Usingknowledgeto:• Describeanalyzerandtestproceduremethodologies• Listsampletypesandcollectionmethods• Describeproceduresforreferenceintervaldetermination• Listerrorsandinterferences(pre-analytical,analyticandpost-analytical)• Definetestproperties(sensitivity,specificity,predictivevalues,ROC,etc.)and

selection• Describequalitycontrol,qualityassurance,relevantstatistics• Describeproceduresforreferenceintervalandmethodvalidationprinciples• Describeroutine,specialandimmunochemicalstains• Describeprinciplesoflightmicroscopy• Listtherulesandregulationsforlaboratorysafetyandbiosafety



Usingknowledgeofpathogenesis,etiologyandorgan-basedcausestoanswerquestionsconcerningthefollowingdiseaseprocesses:• Geneticalteration• Disturbanceofgrowth/neoplasia• Cellaging/degeneration/injury/death• Infection/immunity/inflammation• Metabolic/nutritional/deficiency• Hemodynamic/vasculardisease

TASK6Demonstrateknowledgeofthebasicmechanismsofdisease• Testedvianon-imagebasedMCQs• 100%ofPhaseI(SeePhaseITopicDistributionbelow)


o Cellularinjuryo Inflammationandrepair

212


o Hemodynamicdisorderso Physicalandchemicalinjuryo Neoplasiao Congenitalandgeneticdiseaseso Molecularpathologyo Infectiousprocesseso Immunology





TASK8Demonstrateproficiencyinlaboratorymanagementandqualitypractices




• DemonstrateoveralllaboratorymanagementaptitudePhaseIIBlueprintCategoryTargetsDistributionbySpecies(PhaseII)S1Domestic 70–85% S2Labanimal 10–15% S3Non-domestic 5–10% DistributionbyOrgansystem(PhaseII) O1 Hemolymphatic,includingcoagulation 20–25%O2 Skin/Integument 6–12%O3 Cardiovascular 2–4%O4 Gastrointestinal 2–6%O5 Pancreas,exocrine 2–6%O6 Liver 12–15%O7 Endocrine 8–12%

213


O8 Renal,includingurinalysisandurinarytract 15–20%O9 Respiratory 2–6%O10 Nervousandspecialsenses 2–4%O11 Musculoskeletal 2–6%O12O13O14

ReproductiveMultiorgan/Systemic/OtherNon-organbased*

2–4%2–6%10–20%

*Definedasmostlyprinciplesoflaboratorytechnology,fromselecteditemsinTasks2and4.

Distributionbytopic(PhaseII) C1Genetic 5–10%C2Disturbanceofgrowth/neoplasia 20–30%C3Cellaging/degeneration/injury/death ~5% C4Infection/immunity/inflammation 25–35% C5Metabolic/includingendocrinopathy,acidbase,10–15%abnormalbiochemistry C6Hemodynamic/vasculardisease ~5% C7Laboratorytechnology/analysis 15–20% PhaseI(GeneralPathologyBlueprint)Distributionbytopic(PhaseIExaminationtargets,sameforbothAnatomicalandClinicalPathology)C1Genetic 5–10%C2Disturbanceofgrowth/neoplasia 15–25%C3Cellaging/degeneration/injury/death 5–15%C4Infection/immunity/inflammation35–55%C5Metabolic/nutritional/deficiency5–10%C6Hemodynamic/vasculardisease 5–10%C7Laboratorytechnology/analysis 3–5%

214


american college of veterinary pathologists 2016 …...proficiency in laboratory and quality...

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