laboratory training program milestones training milestones_071415_final.pdf · laboratory training...

Laboratory Training Program Milestones

In 2012, the Association of Professors of Human and Medical Genetics (APHMG) Laboratory Fellowship Program Directors' Special Interest Group (SIG) established a working group* to create Milestones for laboratory-based training, in order to provide a uniform training framework as well as a tool for trainee evaluation applicable across all laboratory specialties. The working group developed these milestones with input from SIG members, representatives of the Accreditation Council for Graduate Medical Education (ACGME), and a group of recent graduates. The final document was accepted by the ABMGG Board of Directors (BOD) in October 2015, and is a required component of ABMGG-accredited training evaluations beginning in July 2016.

The ABMGG Laboratory Training Milestones (“Milestones”) define performance levels for the skills, knowledge, and behaviors across the ACGME’s six competency domains: Patient Care, Medical Knowledge, Practice-Based Learning, Professionalism, System-Based Practice, and Interpersonal and Communication Skills. The purpose of evaluating trainees’ progress on the Milestones is threefold: to support the educational process; to provide evidence of accountability to the Public, the ABMGG, the program, and the trainees; and to demonstrate that each graduate is competent in the skills necessary to succeed in the Medical Genetics and Genomics specialty(ies) in which they train.

The Milestones should be incorporated into each program’s existing evaluation processes and used at regular intervals for each trainee. The Milestones are only one component of the overall evaluation process, and should not be considered the sole measure of progress and competency.

*The ABMGG is grateful to the Laboratory Fellowship Program Directors SIG Working Group:Drs. Tena Cherry, Tina Cowan, Linda Jeng (chair), and Rhona Schreck, for their work in developing the Milestones.

American Board of Medical Genetics and Genomics Laboratory Training Program Milestones

1

Trainee Name: Program Director Name:

Specialty: Evaluation Date:

Dates in Training: Program Name:

Performs Laboratory Testing – Patient Care

Level 1 Level 2 Level 3 Level 4 Level 5

Identifies the general purpose and principles of clinical laboratory tests (eg. as they differ from research testing)

Describes the elements of a Standard Operating Procedure (SOP)

Explains pre-analytic, analytic, and post-analytic components of testing

Identifies limitations of testing methods

Describes clinical indications for testing

Identifies sources of assay failure

Identifies inappropriate test requests

Selects the appropriate methodology or target for testing

Assesses the elements of test validation

Demonstrates the ability to perform testing independently

Identifies and corrects sources of assay and equipment failure

Develops and validates a new test

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2

Evaluates Laboratory Data – Patient Care


Outlines steps of data collection

Evaluates raw laboratory data with supervision

Identifies when an assay has failed

Evaluates acceptability of quality control (QC)

Defines the purpose and utility for quality controls

Applies reference ranges to the interpretation of a result

Analyzes and interprets raw laboratory data with minimal assistance

Describes normal variability of results

Identifies findings that require further testing

Analyzes and interprets raw laboratory data independently

Takes appropriate steps when a QC failure occurs

Where appropriate, uses statistical data to evaluate results

Establishes QC criteria



3

Interprets the Clinical Significance – Patient Care


Acknowledges the importance of clinical history in interpreting laboratory results

Defines abnormal and polymorphism/benign findings

Uses medical resources to assess the significance of a novel variant or finding

Classifies findings that are outside of the normal range

Assembles a relevant clinical history

Develops a list of expected abnormalities based on clinical history

Recognizes a result constituting a potential emergency

Utilizes relevant clinical history when interpreting laboratory results

Interprets finding as abnormal or polymorphism/benign

Develops a list of possibilities compatible with an abnormal laboratory result

Applies knowledge of test limitations in formulating an accurate laboratory report

Correlates test results with the clinical history

Proposes additional testing based on test result and/or patient history

Develops functional assay to determine the clinical significance of a novel finding



4

Prepares Written Reports – Patient Care


Identifies the elements of laboratory reports

Composes a complete normal result report

Drafts a written report for an abnormal result

Describes the process of report transmission

Uses proper language, terminology and nomenclature in reports

Describes the process of amending reports

Composes an abnormal result report for a well- known condition

Independently composes concise, clear written reports

Composes a report with findings of unknown significance

Mentors others in the development of complete and concise reports



5

Applies General Principles of Biology, Medicine, Genetics and Genomics to Laboratory Medicine – Medical Knowledge


Describes basic principles of genetics and inheritance

Describes the basic scientific principles genetic and genomic tests

Defines relevant medical terminology

Identifies classic genetic syndromes

Identifies key clinical features of patients undergoing biochemical, cytogenetic and molecular testing

Interprets relevant components of a medical chart

Explains relevant disease mechanisms

Articulates principles of relevant therapeutic approaches

Utilizes principles of medicine and biology to identify appropriate testing

Characterizes a new disease, syndrome or gene



6

Applies Specialty-Specific Principles of Clinical and Laboratory Medicine to Patient Care – Medical Knowledge


Describes basic elements of laboratory safety

Communicates basic principles of biochemical genetics, cytogenetics and/or molecular genetics

Identifies available databases and other online resources relevant to specialty

Describes the techniques of laboratory testing including strengths and limitations

Recognizes major disease categories and testing approaches

Uses SOPs to perform laboratory testing

Identifies key laboratory and clinical features of relevant diseases

Compares elements of laboratory quality control and quality assurance

Utilizes appropriate databases and other online resources

Composes an SOP for a new procedure

Implements a new laboratory methodology



7

Engages in Self-Directed Learning – Practice Based Learning


Identifies available educational resources

Identifies strengths, deficiencies, and limits in one’s knowledge and expertise

Demonstrates computer literacy and basic computer skills

Formulates an improvement plan based on feedback

Uses information technology to optimize learning

Critically reads and interprets scientific literature

Identifies and performs appropriate learning activities

Critically evaluates and integrates information from diverse sources

Corrects deficiencies proactively

Identifies self-directed goals independently

Participates in national advisory committees

Develops nationally recognized materials and approaches for education of others



8

Gives and Receives Feedback – Professionalism


Receives feedback constructively

Completes program evaluations

Modifies practice in response to feedback

Provides constructive feedback to trainee mentors

Improves performance based on feedback

Encourages and actively seeks feedback to improve performance

Models exemplary behavior when giving and receiving feedback



9

Demonstrates Accountability and Integrity – Professionalism


Shows awareness of laboratory testing turnaround times

Adheres to professional responsibilities

Respects assigned schedules

Completes assigned tasks in a timely manner

Assists team members when requested

Acknowledges personal errors

Demonstrates accountability with all members of the health care team

Identifies, communicates and corrects errors

Shows sensitivity to the needs of the patient in the timeliness of overall testing process

Anticipates team needs and takes leadership role to independently implement solutions

Acts as a mentor to others

Exemplifies effective management of multiple competing tasks, with reliable follow-up



10

Appreciates the Laboratory as Part of the Larger Health Care System – System-Based Practice


Shows awareness of governmental agencies regulating laboratory testing

Recognizes the role of HIPAA in patient care

Shows awareness of the requirements for institutional human subjects research

Recognizes test cost, test benefit, and effect on patient management

Uses EMR/LIS effectively

Demonstrates familiarity with CPT codes and test pricing

Evaluates quality and proficiency testing results

Constructs an appropriate cost benefit analysis or return on investment (ROI) analysis

Evaluates laboratory compliance with federal and state regulatory standards

Shows awareness of reimbursement issues

Participates in writing national guidelines or consensus statements

Formulates system policy regarding test utilization

Participates in local or national professional committees



11

Practices Effective Communication with Colleagues, Patients and Families – Interpersonal and Communication skills


Shows awareness of the importance of communication between all members of the health care team (including laboratory)

Participates in providing oral communication

Communicates results accurately with minimal supervision

Explains results clearly to appropriate individuals independently (eg. patient and/or family members)

Provides accurate consultation to providers regarding laboratory testing

Mentors others in communicating sensitive results to patients and families



12

Functions and Cooperates Within the Health Care Team – Interpersonal and Communication Skills


Shows respect for all members of the team

Provides timely communication with laboratory staff

Actively participates as a member of the health care team (eg. patient rounds, clinic conferences, tumor boards)

Uses good written and oral communication skills with other members of the health care team

Assists other members of the health care team to optimize patient care

Leads an inter-professional team (e.g., Safety Committee, Hospital QI Committee)

Program Director Signature: _________________________________________________ Date: _________________________________

Program Director Name: _________________________________________________ (Please Print)


Trainee Signature: _________________________________________________ Date: _________________________________

Trainee Name: _________________________________________________ (Please Print)

laboratory training program milestones training milestones_071415_final.pdf · laboratory training...

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