Anatomical Pathology

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □Part A: ME 1.3 Apply knowledge of normal anatomy, physiology, and biochemistry
• □Part A: ME 1.3 Apply knowledge of principles of cell biology, immunology, genetics, and pathogenic mechanisms, and the changes that occur in disease states
• □Part A: ME 1.3 Apply basic knowledge of normal gross and light microscopic appearance of tissues
• □Part A: ME 2.2 Identify basic principles of specimen adequacy as they apply to surgical and cytopathology specimens
• □Part A: ME 3.3 Recognize and discuss the importance of the triaging and timing of a procedure or therapy
• □Part A: ME 5.2 Apply safe practices in the laboratory, intraoperative consultation suite, and autopsy suite, to minimize occupational risk

Communicator

• □Part A: COM 4.1 Organize information in appropriate sections within an electronic or written medical record

Collaborator

• □Part A: COL 2.1 Respond to requests and feedback in a respectful and timely manner

Leader

• □Part A: L 1.2 Demonstrate knowledge of laboratory safety initiatives
• □Part A: L 1.4 Describe the data available from health information systems to optimize patient care

Professional

• □Part A: P 1.1 Demonstrate punctuality
• □Part A: P 1.1 Complete assigned responsibilities

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Location

1. ●surgical pathology
2. ●cytopathology
3. ●autopsy pathology
4. ●other

Medical Expert

• □ME 1.3 Apply knowledge of normal anatomy, physiology, and biochemistry
• □ME 1.3 Apply knowledge of principles of cell biology, immunology, genetics, and pathogenic mechanisms, and the changes that occur in disease states
• □ME 2.2 Obtain a relevant clinical history
• □ME 2.2 Interpret history and relevant investigations in light of the clinical question
• □ME 2.2 Synthesize and organize clinical information for clear and succinct presentation to supervisor

Communicator

• □COM 2.3 Seek and integrate relevant information from other sources

Health Advocate

• □HA 1.1 Analyze a given patient’s needs for health services or resources related to the scope of Anatomical Pathology

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □Part A: ME 1.3 Apply basic knowledge of normal gross and light microscopic appearance of tissues
• □Part A: ME 1.3 Apply knowledge of how a light microscope works
• □Part A: ME 3.4 Use a light microscope to examine microscopic slides
• □Part A: ME 3.4 Perform basic microscope maintenance

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Scholar

• □Part A: S 1.2 Use feedback to enhance self-assessment and improve learning
• □Part A: S 1.1 Create a learning plan in collaboration with a designated supervisor identifying learning needs related to Anatomical Pathology and career goals
• □Part A: S 1.1 Use technology to support learning in medicine
• □Part B: S 1.2 Identify and record learning needs that arise in daily work, and apply strategies to address those gaps
• □Part B: S 3.3 Identify relevant sources of information
• □Part B: S 3.3 Determine the validity and risk of bias in a source of evidence
• □Part B: S 4.5 Summarize and communicate to peers the findings of a literature search

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Observation

1. ●direct
2. ●indirect

Medical Expert

• □ME 5.2 Organize work station to ensure safe practices in the laboratory
• □ME 5.2 Take universal precautionary measures to minimize hazardous exposures including potential infectious and chemical agents
• □ME 5.2 Use personal protective measures, including gowns, goggles, and slash resistance gloves
• □ME 1.3 Apply knowledge of normal anatomy and gross appearances of tissues
• □ME 1.3 Apply knowledge of the principles of tissue fixation, decalcification, processing, and the potential impact of improper handling of fresh tissues
• □ME 2.2 Obtain a relevant clinical history
• □ME 3.4 Perform appropriate dissection, description, and sampling of surgical specimens for routine and ancillary procedures
• □ME 3.4 Work efficiently, ensuring appropriate fixation in a timely manner
• □ME 3.4 Seek assistance as needed

Communicator

• □COM 4.1 Document using standardized grossing templates and/or descriptions and protocols as much as possible

Leader

• □L 4.1 Organize work using strategies that address strengths and identify areas to improve in personal effectiveness

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Organ System

1. ●breast
2. ●bone & soft tissue
3. ●gynecology
4. ●gastrointestinal
5. ●genito- urinary
6. ●head & neck
7. ●endocrine
8. ●skin
9. ●cardio vascular
10. ●thoracic
11. ●neuropathology
12. ●lymph nodes & spleen

Medical Expert

• □ME 1.3 Apply knowledge of the principles of tissue fixation, decalcification, processing, and the impact of improper handling of fresh tissues
• □ME 1.3 Apply knowledge of routine histochemical staining
• □ME 1.3 Apply basic knowledge of normal gross and light microscopic appearance of tissues
• □ME 1.3 Apply knowledge of the principles of and indications for immunohistochemistry and special histochemical stains
• □ME 2.2 Develop a differential diagnosis
• □ME 2.2 Perform a pathological examination that is focused and relevant
• □ME 2.2 Select and/or interpret investigations
• □ME 2.2 Synthesize patient information to determine diagnosis
• □ME 3.4 Seek assistance as needed

Communicator

• □COM 4.1 Document microscopic assessment accurately
• □COM 4.1 Generate a clear, concise report that enhances patient management
• □COM 4.1 Identify and correct vague or ambiguous documentation
• □COM 4.1 Integrate information from ancillary studies and other sources into the pathology report if applicable
• □COM 4.1 Incorporate the data available from health information systems in the formation of their differential diagnosis and final report

Leader

• □L 4.1 Build relationships with mentors and faculty

Scholar

• □S 1.2 Identify, record, prioritize and address learning needs that arise in daily work using various strategies (e.g., scanning the literature, or attending formal or informal education sessions)
• □S 3.1 Recognize uncertainty and knowledge gaps in clinical and other professional encounters relevant to Anatomical Pathology

Professional

• □P 1.1 Complete assigned responsibilities
• □P 2.2 Demonstrate a commitment to patient safety and quality improvement through adherence to institutional policies and procedures

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Type of observation

1. ●direct observation of history
2. ●direct observation of communication with patients
3. ●case discussion or chart review

Setting

1. ●Medicine
2. ●Surgery
3. ●Oncology
4. ●Pediatrics
5. ●other

Medical Expert

• □ME 1.1 Demonstrate compassion for patients
• □ME 2.2 Obtain a relevant clinical history
• □ME 2.2 Perform a physical exam that informs the diagnosis
• □ME 2.2 Select and/or interpret investigations
• □ME 2.2 Develop a differential diagnosis
• □ME 2.2 Synthesize and organize clinical information for clear and succinct presentation to supervisor
• □ME 2.4 Identify and/or monitor key clinical features in the implementation of a management plan

Communicator

• □COM 2.1 Use patient-centred interviewing skills
• □COM 3.1 Convey information to the patient and/or family clearly and compassionately
• □COM 3.1 Verify and validate the patient’s and/or family’s understanding of their care
• □COM 4.1 Document the essential elements of a clinical encounter using a structured approach

Collaborator

• □COL 1.2 Work effectively as a member of the clinical team

Professional

• □P 1.1 Complete assigned responsibilities ANATOMICAL PATHOLOGY (2019)

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □Part A: ME 1.6 Seek assistance in situations that are complex or new
• □Part A: ME 2.1 Identify and explore clinical issues to be addressed in the pre-analytical, analytical and post-analytical handling of a case
• □Part A: ME 2.2 Obtain a relevant clinical history
• □Part A: ME 3.2 Describe the provincial and institutional rules governing consent for autopsy
• □Part A: ME 3.2 Identify the features of an appropriate autopsy consent
• □Part A: ME 4.1 Recognize when a case requires involvement of the medical examiner
• □Part A: ME 2.2 Synthesize and organize clinical information for clear and succinct presentation to supervisor
• □Part B: ME 5.2 Apply safe practices in the laboratory, intraoperative consultation suite, and autopsy suite, to minimize occupational risk
• □Part B: ME 1.3 Apply knowledge of normal anatomy, physiology, and biochemistry
• □Part B: ME 1.3 Apply basic knowledge of normal gross and light microscopic appearance of tissues
• □Part B: ME 1.3 Apply knowledge of the principles of embryologic development and common variations of normal development
• □Part B: ME 2.1 Identify and explore clinical issues to be addressed in the pre-analytical, analytical and post-analytical handling of a case
• □Part B: ME 2.2 Perform a pathological examination that is focused and relevant
• □Part B: ME 3.4 Perform basic procedures in autopsy pathology
• □Part B: ME 1.6 Seek assistance in situations that are complex or new
• □Part B: ME 3.4 Photograph specimens

Communicator

• □Part A: COM 4.1 Identify and correct vague or ambiguous documentation

Collaborator

• □Part A: COL 1.3 Communicate with clinical staff regarding issues of consent and clinical questions that need to be addressed

Scholar

• □Part A: S 3.1 Generate focused questions that address practice uncertainty and knowledge gaps
• □Part B: S 1.2 Seek and interpret multiple sources of performance data and feedback, with guidance, to continually improve performance

Professional

• □Part A: P 3.1 Describe local regulations regarding the reporting of deaths to the medical examiner or coroner

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Ancillary tests required or anticipated

1. ●immunohistochemistry
2. ●cytogenetics
3. ●molecular
4. ●in situ hybridization
5. ●immunofluorescence
6. ●flow cytometry
7. ●electron microscopy

Lymphoma protocol

1. ●yes
2. ●no

Medical Expert

• □ME 1.4 Recognize urgent problems that may need the involvement of more experienced colleagues and seek their assistance
• □ME 1.6 Develop a plan that considers the current complexity, uncertainty, and ambiguity in a clinical situation
• □ME 3.1 Recognize when a specimen might require ancillary studies
• □ME 3.1 Describe the indications, contraindications, risks, and alternatives for a given test
• □ME 2.2 Assess specimen adequacy for ancillary testing
• □ME 3.3 Prioritize routine and ancillary studies when specimen adequacy is limited
• □ME 3.4 Maintain the integrity required for the specific ancillary study (e.g., nucleic acid integrity for molecular testing, cell membrane for flow cytometry, viable cells for cytogenetics)

Collaborator

• □COL 1.3 Consult with clinical colleagues, when appropriate, to ascertain if ancillary studies would be of value
• □COL 1.1 Receive and appropriately respond to input from other health care professionals (e.g., pathology assistants, technologists)

Leader

• □L 2.2 Apply evidence and guidelines with respect to resource utilization in common clinical scenarios

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Organ system

1. ●breast
2. ●bone & soft tissue
3. ●skin
4. ●gynecology
5. ●gastrointestinal
6. ●genitourinary
7. ●endocrine
8. ●head & neck
9. ●lymph nodes & spleen
10. ●neuropathology
11. ●thoracic

Pediatric

1. ●yes
2. ●no

Medical Expert

• □ME 1.3 Apply knowledge of normal gross examination
• □ME 2.2 Perform a pathological examination that is focused and relevant
• □ME 2.2 Review clinical history, imaging and other relevant data as necessary
• □ME 3.4 Perform gross dissection, description and sampling of surgical specimens, applying meticulous attention to block selection and mapping using diagrams and images and demonstrating awareness of downstream synoptic reporting and staging parameters, and the need to save tissue for research, tissue bank and other indications, as necessary
• □ME 5.2 Apply safe practices in the laboratory, intraoperative consultation suite and autopsy suite to minimize occupational risk
• □ME 3.4 Seek assistance as needed
• □ME 3.4 Take high quality photographs of specimens
• □ME 2.2 Formulate a differential diagnosis based on the pathological examination

Communicator

• □COM 4.1 Communicate findings in a timely fashion, with appropriate documentation

Leader

• □L 1.1 Participate in quality management by minimizing cross contamination and using standardized grossing templates and protocols as appropriate

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Organ system

1. ●breast
2. ●bone & soft tissue
3. ●skin
4. ●gynecology
5. ●gastrointestinal (including hepatobiliary/pancreas)
6. ●genitourinary
7. ●endocrine
8. ●head & neck
9. ●lymph nodes & spleen
10. ●neuropathology
11. ●thoracic

Pediatric

1. ●yes
2. ●no

Medical Expert

• □ME 1.3 Apply knowledge of normal gross examination
• □ME 2.2 Perform a pathological examination that is focused and relevant
• □ME 2.2 Review clinical history, imaging and other relevant data as necessary
• □ME 3.4 Perform gross dissection, description and sampling of surgical specimens, applying meticulous attention to block selection and mapping using diagrams and images and demonstrating awareness of downstream synoptic reporting and staging parameters, and the need to save tissue for research, tissue bank and other indications, as necessary
• □ME 5.2 Apply safe practices in the laboratory, intraoperative consultation suite and autopsy suite to minimize occupational risk
• □ME 3.4 Seek assistance as needed
• □ME 3.4 Take high quality photographs of specimens
• □ME 2.2 Formulate a differential diagnosis based on the pathological examination

Communicator

• □COM 4.1 Communicate findings in a timely fashion, with appropriate documentation

Collaborator

• □COL 2.1 Delegate tasks and responsibilities in an appropriate and respectful manner

Leader

• □L 1.1 Participate in quality management by minimizing cross contamination and using standardized grossing templates and protocols as appropriate

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Organ system

1. ●breast
2. ●bone & soft tissue
3. ●skin
4. ●gynecology
5. ●gastrointestinal
6. ●genitourinary
7. ●endocrine
8. ●head & neck
9. ●lymph nodes & spleen
10. ●neuropathology
11. ●thoracic

Pediatric

1. ●yes
2. ●no

Specimen type

1. ●biopsy
2. ●resection
3. ●other

Medical Expert

• □ME 1.3 Apply knowledge of gross and microscopic appearances of tissues in disease states
• □ME 1.3 Apply knowledge of the principles of and indications for ancillary diagnostic techniques
• □ME 2.2 Perform a gross and microscopic pathological examination that is focused and relevant
• □ME 1.6 Seek assistance in situations that are complex or new
• □ME 2.2 Obtain a relevant clinical history
• □ME 2.2 Formulate a differential diagnosis based on the pathological examination
• □ME 2.2 Select ancillary techniques judiciously in a resource-effective and ethical manner
• □ME 3.4 Use digital microscopy and interpret gross and microscopic digital images, including digitized and scanned slides
• □ME 2.2 Establish a final diagnosis that takes into account clinical correlations
• □ME 5.2 Apply the principles of situational awareness to clinical practice
• □ME 1.4 Complete pathology reports within appropriate turnaround times

Communicator

• □COM 4.1 Prepare clear, concise, comprehensive, and timely written reports for surgical pathology
• □COM 4.1 Integrate information from ancillary studies and other sources into the pathology report

Collaborator

• □COL 1.3 Convey information from the pathology assessment to clinicians in a manner that enhances patient management

Leader

• □L 2.1 Develop practice-based and system-based rules for resource allocation

Health Advocate

• □HA 1.1 Respond to individual patient diagnostic needs and issues as part of patient care

Scholar

• □S 3.1 Generate focused questions that address practice uncertainty and knowledge gaps

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Organ system

1. ●breast
2. ●bone & soft tissue
3. ●skin
4. ●gynecology
5. ●gastrointestinal
6. ●genitourinary
7. ●endocrine
8. ●head & neck
9. ●lymph nodes & spleen
10. ●neuropathology
11. ●thoracic

Pediatric

1. ●yes
2. ●no

Specimen type

1. ●biopsy
2. ●resection
3. ●other

Medical Expert

• □ME 1.3 Apply knowledge of gross and microscopic appearances of tissues in disease states
• □ME 1.3 Apply knowledge of the principles of and indications for ancillary diagnostic techniques
• □ME 2.2 Perform a gross and microscopic pathological examination that is focused and relevant
• □ME 1.6 Seek assistance in situations that are complex or new
• □ME 2.2 Formulate a differential diagnosis based on the pathological examination
• □ME 2.2 Select ancillary techniques judiciously in a resource-effective and ethical manner
• □ME 3.4 Use digital microscopy and interpret gross and microscopic digital images, including digitized and scanned slides
• □ME 2.2 Establish a final diagnosis that takes into account clinical correlations
• □ME 4.1 Determine the need and timing of referral to another specialist and/or second opinion
• □ME 1.4 Complete pathology reports within appropriate turnaround times

Communicator

• □COM 4.1 Prepare clear, concise, comprehensive, and timely written reports, for surgical pathology
• □COM 4.1 Integrate information from ancillary studies and other sources into the pathology report
• □COM 4.1 Use synoptic and other standardized reporting formats as appropriate

Collaborator

• □COL 1.3 Convey information from the pathology assessment to clinicians in a manner that enhances patient management
• □COL 2.1 Delegate tasks and responsibilities in an appropriate and respectful manner

Scholar

• □S 3.1 Generate focused questions that address practice uncertainty and knowledge gaps

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □Part A: ME 3.2 Ensure autopsy consent has been obtained and documented correctly
• □Part A: ME 1.3 Apply knowledge of normal anatomy, physiology, and biochemistry
• □Part A: ME 1.3 Apply knowledge of gross and microscopic appearances of tissues in disease states
• □Part A: ME 1.3 Apply knowledge of the principles of and indications for ancillary diagnostic techniques
• □Part A: ME 1.6 Seek assistance in situations that are complex or new
• □Part A: ME 2.2 Obtain a relevant clinical history
• □Part A: ME 2.2 Perform a pathological examination that is focused and relevant
• □Part A: ME 2.2 Select ancillary techniques judiciously in a resource-effective and ethical manner
• □Part A: ME 3.4 Perform a complete autopsy, with appropriate full description and diagnosis at gross and microscopic levels
• □Part A: ME 5.2 Apply safe practices in the laboratory, intraoperative consultation suite, and autopsy suite, to minimize occupational risk
• □Part A: ME 3.4 Interpret the findings of autopsy in the context of the relevant clinical history
• □Part A: ME 3.4 Document procedures accurately
• □Part B: ME 1.3 Apply knowledge of normal anatomy, physiology, and biochemistry
• □Part B: ME 1.6 Seek assistance in situations that are complex or new
• □Part B: ME 3.4 Perform organ evisceration
• □Part B: ME 5.2 Apply safe practices in the laboratory, intraoperative consultation suite, and autopsy suite, to minimize occupational risk
• □Part C: ME 1.3 Apply knowledge of principles of cell biology, immunology, genetics, and pathogenic mechanisms, and the changes that occur in disease states
• □Part C: ME 1.3 Apply knowledge of normal gross, light microscopic, and ultrastructural appearance of tissues
• □Part C: ME 1.3 Apply knowledge of gross and microscopic appearances of tissues in disease states
• □Part C: ME 2.1 Identify and explore clinical issues to be addressed in the pre-analytical, analytical and post-analytical handling of a case
• □Part C: ME 2.2 Perform a gross and microscopic pathological examination that is focused and relevant
• □Part C: ME 3.4 Utilize other areas of laboratory medicine, including microbiology, for diagnostic purposes
• □Part C: ME 3.4 Interpret the findings of autopsy in the context of the relevant clinical history
• □Part C: ME 4.1 Determine the need and timing of referral to another specialist and/or second opinion

Communicator

• □Part A: COM 4.1 Prepare clear, concise, comprehensive, and timely written reports for autopsy consultations
• □Part B: COM 3.2 Communicate and document issues arising from a breach in quality or safety of laboratory practice
• □Part C: COM 4.1 Prepare clear, concise, comprehensive, and timely written reports for autopsy consultations
• □Part C: COM 4.1 Integrate information from ancillary studies and other sources into the pathology report

Collaborator

• □Part A: COL 1.2 Work effectively with laboratory technologists and pathology assistants, directing their assistance
• □Part B: COL 1.2 Work effectively with laboratory technologists and pathology assistants, directing their assistance
• □Part B: COL 2.1 Delegate tasks and responsibilities in an appropriate and respectful manner
• □Part C: COL 1.2 Consult as needed with other health care professionals, including other physicians

Leader

• □Part B: L 1.2 Actively encourage all involved in health care, regardless of their role, to report and respond to unsafe situations

Scholar

• □Part B: S 1.2 Seek and interpret multiple sources of performance data and feedback, with guidance, to continually improve performance
• □Part C: S 3.1 Generate focused questions that address practice uncertainty and knowledge gaps

Professional

• □Part C: P 3.1 Fulfil the requirements of the physician’s duty to report
• □Part C: P 3.3 Prepare an autopsy for presentation at M&M rounds or departmental autopsy rounds

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Case type

1. ●natural death
2. ●multiple trauma
3. ●decomposed remains
4. ●intoxication
5. ●hanging
6. ●bodies from uncontrolled environments
7. ●post-procedure death
8. ●other

Manner of death

1. ●natural
2. ●accident
3. ●suicide
4. ●undetermined

Special dissections performed

1. ●yes
2. ●no

Medical Expert

• □Part A: ME 3.2 Ensure autopsy consent has been obtained and documented correctly
• □Part A: ME 2.2 Obtain a relevant clinical history
• □Part A: ME 2.2 Perform a pathological examination that is focused and relevant
• □Part A: ME 2.2 Recognize common forensic artifacts
• □Part A: ME 2.2 Select ancillary techniques judiciously in a resource-effective and ethical manner
• □Part A: ME 3.4 Perform a complete forensic autopsy, including but not limited to toxicological examination and the submission of specimens to the forensic sciences laboratory
• □Part A: ME 1.3 Apply knowledge of gross and microscopic appearances of tissues in disease states
• □Part A: ME 1.3 Apply knowledge of the principles of and indications for ancillary diagnostic techniques
• □Part A: ME 1.6 Seek assistance in situations that are complex or new
• □Part A: ME 2.1 Identify and explore clinical issues to be addressed in the pre-analytical, analytical and post-analytical handling of a case
• □Part A: ME 3.4 Interpret the findings of autopsy in the context of the relevant clinical history
• □Part B: ME 1.3 Apply knowledge of gross and microscopic appearances of tissues in disease states
• □Part B: ME 2.1 Identify and explore clinical issues to be addressed in the pre-analytical, analytical and post-analytical handling of a case
• □Part B: ME 2.2 Interpret the findings of autopsy in the context of the relevant clinical history

Communicator

• □Part B: COM 4.1 Prepare clear, concise, comprehensive, and timely written reports for autopsy consultations
• □Part B: COM 4.1 Integrate information from ancillary studies and other sources into the pathology report

Collaborator

• □Part A: COL 1.2 Work effectively with laboratory technologists and pathology assistants, directing their assistance

Scholar

• □Part A: S 3.1 Generate focused questions that address practice uncertainty and knowledge gaps
• □Part B: S 3.1 Generate focused questions that address practice uncertainty and knowledge gaps

Professional

• □Part A: P 3.1 Demonstrate understanding of the laws and policies relevant to conducting forensic investigations
• □Part A: P 3.1 Adhere to requirements related to reportable diseases, including infectious diseases
• □Part A: P 3.1 Describe local regulations regarding the reporting of deaths to the medical examiner or coroner
• □Part B: P 2.1 Demonstrate a commitment to the promotion of the public good in health care, including stewardship of resources
• □Part B: P 3.1 Demonstrate understanding of the laws and policies relevant to conducting forensic investigations
• □Part B: P 3.1 Adhere to requirements related to reportable diseases, including infectious diseases

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Type

1. ●fetal
2. ●neonatal
3. ●pediatric

Medical Expert

• □Part A: ME 2.1 Identify and explore clinical issues to be addressed in the pre-analytical, analytical and post-analytical handling of a case
• □Part A: ME 2.2 Obtain a relevant clinical history
• □Part A: ME 2.2 Perform a pathological examination that is focused and relevant
• □Part A: ME 3.4 Perform a complete pediatric autopsy, with appropriate full description and diagnosis at gross and microscopic levels
• □Part A: ME 1.3 Apply knowledge of normal gross, light microscopic, and ultrastructural appearance of tissues
• □Part A: ME 1.3 Apply knowledge of the principles of embryologic development and common variations of normal development
• □Part A: ME 1.3 Apply knowledge of gross and microscopic appearances of tissues in disease states
• □Part A: ME 1.3 Apply knowledge of the principles of and indications for ancillary diagnostic techniques
• □Part A: ME 1.6 Seek assistance in situations that are complex or new
• □Part A: ME 2.2 Select ancillary techniques judiciously in a resource-effective and ethical manner
• □Part A: ME 5.1 Report patient safety incidents to appropriate institutional representatives
• □Part B: ME 1.3 Apply basic knowledge of normal gross, light microscopic, and ultrastructural appearance of tissues
• □Part B: ME 1.3 Apply knowledge of the principles of embryologic development and common variations of normal development
• □Part B: ME 1.3 Apply knowledge of gross and microscopic appearances of tissues in disease states
• □Part B: ME 2.1 Identify and explore clinical issues to be addressed in the pre-analytical, analytical and post-analytical handling of a case
• □Part B: ME 2.2 Perform a gross and microscopic pathological examination that is focused and relevant
• □Part B: ME 3.4 Utilize other areas of laboratory medicine, including microbiology, for diagnostic purposes
• □Part B: ME 3.4 Interpret the findings of autopsy in the context of the relevant clinical history

Communicator

• □Part A: COM 4.1 Prepare clear, concise, comprehensive, and timely written reports for autopsy consultations
• □Part B: COM 4.1 Prepare clear, concise, comprehensive, and timely written reports for autopsy consultations
• □Part B: COM 4.1 Integrate information from ancillary studies and other sources into the pathology report

Collaborator

• □Part A: COL 2.1 Delegate tasks and responsibilities in an appropriate and respectful manner

Health Advocate

• □Part A: HA 1.1 Respond to findings related to inheritable conditions that may be of significance in disease prevention or early detection (e.g., genetic diseases that may affect a sibling)
• □Part B: HA 1.2 Alert treating physicians when potentially detectable inherited conditions are encountered (e.g., genetic diseases that may affect a sibling)

Scholar

• □Part A: S 3.1 Generate focused questions that address practice uncertainty and knowledge gaps
• □Part B: S 3.1 Generate focused questions that address practice uncertainty and knowledge gaps

Professional

• □Part B: P 1.1 Manage complex issues while preserving confidentiality
• □Part B: P 3.1 Fulfil the requirements of the physician’s duty to report

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Organ system

1. ●breast
2. ●bone & soft tissue
3. ●skin
4. ●gynecology
5. ●gastrointestinal
6. ●genitourinary
7. ●endocrine
8. ●head & neck
9. ●lymph nodes & spleen
10. ●neuropathology
11. ●thoracic

Genetic abnormality type

1. ●cytogenetic type
2. ●sequence level

Test type

1. ●in-situ hybridization
2. ●PCR-based testing
3. ●cytogenetics
4. ●next-generation sequencing
5. ●other

Medical Expert

• □ME 1.3 Apply knowledge of principles of cell biology, immunology, genetics, and pathogenic mechanisms, and the changes that occur in disease states
• □ME 1.3 Apply knowledge of general concepts related to the human genome, human genes, and inheritance of DNA
• □ME 1.3 Apply knowledge of general concepts of inherited and somatic disease
• □ME 1.3 Apply knowledge of the essential elements of adequate analytical validation for genetics-based tests
• □ME 1.3 Apply knowledge of the principles of and indications for ancillary diagnostic techniques
• □ME 1.3 Apply knowledge of appropriate sample requirements and handling
• □ME 3.1 Describe the advantages and limitations of molecular testing as an adjunct to cytopathologic evaluation of cellular specimens
• □ME 2.2 Select additional testing based on an appreciation of the diagnostic possibilities, the clinical context and the relevance and capabilities of available technologies
• □ME 4.1 Coordinate the use of multiple diagnostic investigations so as to ensure complementarity and efficiency
• □ME 3.3 Prioritize routine and ancillary investigations when specimen adequacy is limited
• □ME 5.1 Recognize sources of analytical error for various molecular tests
• □ME 2.2 Interpret molecular diagnostic test results together with available clinical and histopathological data

Communicator

• □COM 4.1 Integrate molecular results into the anatomical pathology report

Leader

• □L 2.1 Utilize genetic testing resources effectively to balance costs with potential utility of results

Health Advocate

• □HA 1.2 Describe the role of molecular methods used to screen for inherited/familial cancer syndromes

Scholar

• □S 3.3 Critically assess the current knowledge as related to molecular diagnostics in the practice of AP with special emphasis in oncology and inherited diseases

Professional

• □P 1.3 Describe the role and apply knowledge of the ethics of genetic screening in family planning and for hereditary cancers
• □P 3.1 Ensure compliance with privacy regulations as they apply to the use of genetic information
• □P 3.1 Recognize the medicolegal implications in the practice of genetics

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Organ system

1. ●breast
2. ●bone & soft tissue
3. ●skin
4. ●gynecology
5. ●gastrointestinal
6. ●genitourinary
7. ●endocrine
8. ●head & neck
9. ●lymph nodes & spleen
10. ●neuropathology
11. ●thoracic

Specimen type

1. ●cytology
2. ●other

Test type

1. ●immunohistochemistry
2. ●special histochemical stains
3. ●flow cytometry
4. ●immunofluorescence
5. ●electron microscopy
6. ●other

Medical Expert

• □ME 1.3 Apply knowledge of principles of cell biology, immunology, genetics, and pathogenic mechanisms, and the changes that occur in disease states
• □ME 1.3 Apply knowledge of gross and microscopic appearances of tissues in disease states
• □ME 1.3 Apply knowledge of the principles of and indications for ancillary diagnostic techniques
• □ME 1.6 Seek assistance in situations that are complex or new
• □ME 1.6 Convey diagnostic uncertainty and recommend additional studies when needed
• □ME 2.2 Select and/or interpret investigations
• □ME 2.2 Assess specimen adequacy for ancillary testing
• □ME 2.2 Select ancillary techniques judiciously in a resource-effective and ethical manner
• □ME 3.4 Recognize patterns of familial cancer syndromes, using or suggesting appropriate ancillary tests to guide genetic counseling

Communicator

• □COM 4.1 Integrate information from ancillary studies and other sources into the pathology report

Leader

• □L 1.1 Apply quality management principles such as the use of controls (e.g., internal, external, reagent and tissue) to ensure validity of study findings and apply this understanding to troubleshooting test failure
• □L 2.1 Use clinical judgment to minimize wasteful practices

Health Advocate

• □HA 1.2 Respond to individual patient diagnostic needs and issues as part of patient care

Scholar

• □S 3.1 Generate focused questions that address practice uncertainty and knowledge gaps

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Specimen type

1. ●gynecological
2. ●fine-needle aspiration (FNA)
3. ●fluids (pleural, peritoneal, urine, CSF, etc.)
4. ●endoscopic ultrasound (EUS)
5. ●endobronchial ultrasound (EBUS)
6. ●other

Component

1. ●adequacy
2. ●preparation
3. ●assessment of finished product

Medical Expert

• □Part A: ME 2.1 Determine if cytopathology specimens and requisitions meet adequacy criteria
• □Part A: ME 2.1 Describe reasons for specimen rejection and the process of rejection documentation
• □Part A: ME 5.1 Resolve issues related to specimen misidentification
• □Part A: ME 2.1 Identify and explore clinical issues to be addressed in the pre-analytical handling of a cytology case
• □Part A: ME 1.3 Apply knowledge of the principles of and indications for ancillary diagnostic techniques in cytopathology
• □Part A: ME 3.4 Prepare gynecological and non-gynecological cytopathology specimens, including staining, cover-slipping, triaging and storage
• □Part A: ME 5.2 Apply safe practices in the laboratory, intraoperative consultation suite and autopsy suite to minimize occupational risk
• □Part B: ME 2.2 Ascertain the clinical scenario and the information a clinical team requires from a request for cytopathology testing
• □Part B: ME 1.3 Apply knowledge of the principles of and indications for ancillary diagnostic techniques in cytopathology

Collaborator

• □Part A: COL 1.3 Communicate effectively with physicians and other colleagues in the health care professions
• □Part B: COL 1.3 Provide advice to clinical colleagues regarding specimen procurement and handling
• □Part B: COL 1.3 Communicate effectively with physicians and other colleagues in the health care professions

Leader

• □Part A: L 2.1 Use clinical judgment to minimize wasteful practices
• □Part A: L 1.1 Participate in quality control, quality assurance and quality improvement initiatives

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Specimen type

1. ●pap smear
2. ●fine-needle aspiration (FNA)
3. ●fluid (pleural, peritoneal, urine, CSF, etc.)
4. ●endoscopic ultrasound (EUS)
5. ●endobronchial ultrasound (EBUS)

Medical Expert

• □ME 1.3 Apply knowledge of the appearance of normal cells in cytologic preparations
• □ME 1.3 Apply knowledge of cytological appearance of cells in disease states
• □ME 1.3 Apply knowledge of the principles of and indications for ancillary diagnostic techniques
• □ME 2.1 Identify and explore clinical issues to be addressed in the pre-analytical, analytical and post-analytical handling of a case
• □ME 2.2 Assess specimen adequacy in surgical and cytopathology specimens
• □ME 2.2 Describe common pitfalls in diagnosis of cytopathological specimens
• □ME 2.2 Identify and interpret epithelial cell abnormalities of squamous and glandular cells
• □ME 4.1 Determine the need and timing of referral to another specialist and/or second opinion

Communicator

• □COM 4.1 Prepare clear, concise, comprehensive, and timely written reports for cytopathology consultations
• □COM 4.1 Use standardized terminology for reporting results, as relevant
• □COM 4.1 Provide educational notes and recommendations when needed in the report
• □COM 4.1 Use standardized non-diagnostic (e.g., cyst contents) and diagnostic (e.g., unsatisfactory/ benign/ atypical/ suspicious/ malignant) general categories for reporting results (non-Gyne)
• □COM 4.1 Provide descriptive diagnoses that will clearly communicate cellular findings for those anatomic sites where there is no standardized terminology (FNA)
• □COM 4.1 Convey critical values or unexpected results in a timely manner

Leader

• □L 2.1 Use clinical judgment to minimize wasteful practices

Scholar

• □S 1.2 Seek and interpret multiple sources of performance data and feedback, with guidance, to continually improve performance
• □S 3.4 Integrate best evidence and clinical expertise into decision-making

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Observation

1. ●direct
2. ●indirect

Organ system

1. ●breast
2. ●bone & soft tissue
3. ●skin
4. ●gynecology
5. ●gastrointestinal
6. ●genitourinary
7. ●endocrine
8. ●head & neck
9. ●lymph nodes & spleen
10. ●neuropathology
11. ●thoracic

Type of preparation

1. ●frozen section
2. ●touch prep
3. ●both

Medical Expert

• □ME 1.3 Apply knowledge of indications, contraindications and limitations of frozen sections
• □ME 2.2 Obtain a relevant clinical history
• □ME 1.3 Apply knowledge about most appropriate method of intraoperative assessment (gross examination only vs frozen sections vs cytologic examination)
• □ME 2.2 Assess specimen adequacy in surgical and cytopathology specimens
• □ME 3.4 Prepare frozen sections, including imprint cytology specimens when relevant and review for diagnosis
• □ME 1.3 Apply knowledge of the appearance of normal cells in cytologic preparations
• □ME 1.3 Apply knowledge of gross and microscopic appearances of tissues in disease states
• □ME 1.3 Apply knowledge of cytological appearance of cells in disease states
• □ME 1.3 Apply knowledge of the principles of and indications for ancillary diagnostic techniques
• □ME 2.2 Formulate a differential diagnosis based on the pathological examination
• □ME 2.2 Establish a final diagnosis that takes into account clinical correlations
• □ME 3.4 Establish and implement a plan for post-procedure handling of tissue
• □ME 5.2 Apply safe practices in the laboratory, intraoperative consultation suite, and autopsy suite to minimize occupational risk

Collaborator

• □COL 1.2 Discuss indications for appropriate use of intra-operative and urgent consultations
• □COL 1.2 Work effectively with laboratory technologists and pathology assistants, directing their assistance
• □COL 1.2 Interact effectively with surgeons during intraoperative consultations
• □COL 1.2 Convey diagnostic uncertainty and discuss deferral of diagnosis when needed
• □COL 1.3 Convey information from the pathology assessment to clinicians in a manner that enhances patient management

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Type of activity

1. ●journal club
2. ●grand rounds
3. ●academic halfday
4. ●other didactic sessions

Scholar

• □S 2.4 Identify the learning needs and desired learning outcomes of others
• □S 2.4 Develop learning objectives for a teaching activity
• □S 3.3 Critically evaluate the integrity, reliability and applicability of health related research and literature
• □S 3.4 Integrate best evidence and clinical expertise
• □S 2.4 Present the information in an organized manner to facilitate understanding
• □S 2.4 Use audiovisual aids effectively
• □S 2.4 Provide adequate time for questions and discussion

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Clinical area

1. ●surgical pathology
2. ●autopsy
3. ●cytopathology
4. ●molecular pathology
5. ●other

Quality management activity

1. ●responding to a finding or occurrence
2. ●participating in a systematic quality assurance activity

Medical Expert

• □Part B: ME 1.3 Define a critical result (critical diagnosis), and describe how it is documented and handled
• □Part B: ME 2.1 Identify and explore clinical issues to be addressed in the pre-analytical, analytical and post-analytical handling of a case
• □Part B: ME 5.1 Recognize near-misses in real time and respond to correct them

Communicator

• □Part B: COM 3.2 Communicate and document issues arising from a breach in quality or safety of laboratory practice
• □Part B: COM 4.1 Convey critical values or unexpected results in a timely manner

Collaborator

• □Part B: COL 1.1 Anticipate, identify, and respond to patient safety issues related to the function of a lab or clinical team
• □Part B: COL 1.3 Communicate effectively with physicians and other colleagues in the health care professions

Leader

• □Part B: L 1.1 Describe the metrics and measurement systems (e.g., statistical benchmarking and dashboard construction) used by the laboratory to track lab activities and current practice patterns
• □Part B: L 1.4 Identify variation/gaps between actual and targeted performance using thresholds
• □Part B: L 1.1 Understand the various process improvement methodologies (PDSA, six-sigma, DMAIC, Lean) and their strengths and weaknesses
• □Part B: L 1.3 Manage a suspected specimen mix-up
• □Part B: L 1.3 Resolve and analyze diagnostic discrepancies
• □Part B: L 1.1 Identify problems, formulate and carry out a plan of action, and reassess the results in the context of quality improvement
• □Part B: L 1.2 Actively encourage all involved in health care, regardless of their role, to report and respond to unsafe situations
• □Part B: L 1.1 Participate in quality control, quality assurance and quality improvement initiatives

Scholar

• □Part B: S 3.4 Apply evidence-based medicine and best practice guidelines
• □Part B: S 3.4 Identify new evidence appropriate to their scope of professional practice through quality-appraised evidence-alerting services

Professional

• □Part B: P 2.1 Demonstrate a commitment to maintaining and enhancing competence
• □Part B: P 2.2 Demonstrate a commitment to patient safety and quality improvement initiatives within their own practice environment

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Leader

• □L 4.1 Organize work to manage clinical, scholarly and other responsibilities

Scholar

• □S 4.4 Identify, consult and collaborate with content experts and others in the conduct of scholarly work
• □S 4.4 Generate focused questions for scholarly investigation
• □S 3.3 Critically evaluate the integrity, reliability, and applicability of health-related research and literature
• □S 4.5 Summarize the findings of a literature review
• □S 4.4 Select appropriate methods of addressing a given scholarly question
• □S 4.2 Identify ethical principles in research
• □S 4.4 Collect data for a scholarly project
• □S 4.4 Perform data analysis
• □S 4.4 Integrate existing literature and findings of data collection
• □S 4.4 Identify areas for further investigation

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Leader

• □L 4.1 Set priorities and manage time to integrate practice and personal life
• □L 4.2 Examine personal interests and seek career mentorship and counselling
• □L 4.2 Reconcile expectations for practice with job opportunities and workforce needs
• □L 4.3 Improve personal practice by evaluating a problem, setting priorities, executing a plan, and analyzing the results

Scholar

• □S 1.1 Create a learning plan in collaboration with a designated supervisor identifying learning needs related to Anatomical Pathology and career goals
• □S 1.2 Identify opportunities for learning and improvement by regularly reflecting on and assessing their performance using various internal and external data sources

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Setting

1. ●cancer clinic
2. ●colposcopy clinic
3. ●endoscopy clinic
4. ●dermatology clinic
5. ●genetics counselling
6. ●other [free text]

Medical Expert

• □Part A: ME 1.3 Apply a broad base and depth of knowledge in the clinical and biomedical sciences to perform a pathology consultation
• □Part A: ME 2.2 Gather and synthesize patient information to establish the clinical question
• □Part A: ME 2.2 Develop a differential diagnosis
• □Part A: ME 2.2 Select and recommend pathology investigations, including molecular pathology
• □Part A: ME 3.4 Recognize patterns of familial cancer syndromes, using or suggesting appropriate ancillary tests to guide genetic counselling
• □Part A: ME 1.6 Demonstrate insight into their own limits of expertise
• □Part B: ME 1.4 Synthesize cases for discussion at multidisciplinary rounds
• □Part B: ME 2.2 Apply tumor staging thresholds and other important prognostic parameters in synoptic reporting in order to position patients in treatment algorithms
• □Part B: ME 1.6 Demonstrate insight into their own limits of expertise

Communicator

• □Part A: COM 3.1 Convey information to patients and families about pathology tests results clearly and compassionately

Collaborator

• □Part A: COL 1.1 Establish positive relationships with other members of the health care team
• □Part A: COL 1.3 Provide advice to clinical colleagues regarding specimen procurement and handling
• □Part A: COL 1.3 Convey information from the pathology assessment to clinicians in a manner that enhances patient management
• □Part A: COL 1.3 Support clinical colleagues in the development and implementation of a management plan, as appropriate
• □Part B: COL 1.3 Convey information from the pathology assessment to clinicians in a manner that enhances patient management
• □Part B: COL 1.3 Support clinical colleagues in the development and implementation of a management plan, as appropriate

Health Advocate

• □Part A: HA 1.1 Respond to individual patient diagnostic needs and issues as part of patient care
• □Part B: HA 1.1 Respond to individual patient diagnostic needs and issues as part of patient care

Scholar

• □Part B: S 3.4 Integrate best evidence and clinical expertise into decision-making

Professional

• □Part B: P 1.1 Exhibit appropriate professional behaviours

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □ME 1.5 Set priorities, triage and manage the workload within accepted turnaround times
• □ME 1.5 Carry out professional duties in the face of multiple, competing demands
• □ME 1.6 Demonstrate insight into their own limits of expertise

Communicator

• □COM 3.2 Communicate and document issues arising from a breach in quality or safety of laboratory practice
• □COM 4.1 Prepare clear, concise, comprehensive and timely written reports for surgical pathology, cytopathology, and autopsy consultations

Collaborator

• □COL 1.3 Convey information from the pathology assessment to clinicians in a manner that enhance patient management

Leader

• □L 4.2 Describe the principles of workload measurement within the laboratory
• □L 3.1 Demonstrate knowledge of the principles of laboratory management, including resource allocation and collaboration with technical managers, and hospital and laboratory administration
• □L 1.1 Demonstrate an awareness of current practice guidelines

Scholar

• □S 3.4 Integrate best evidence and clinical expertise into decision-making

Professional

• □P 1.1 Exhibit appropriate professional behaviours
• □P 3.1 Describe the relevant codes, policies, standards, and laws governing physicians and the profession including standard-setting and disciplinary and credentialing procedures
• □P 4.3 Provide mentorship to residents and colleagues

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Scholar

• □S 2.1 Recognize the influence of role-modelling and the impact of the formal, informal, and hidden curriculum on learners
• □S 2.2 Ensure a safe learning environment for all members of the team
• □S 2.3 Supervise learners to ensure they work within their limits, seeking guidance and supervision when needed
• □S 2.4 Provide teaching and/or other informal learning activities
• □S 2.5 Provide feedback to enhance learning and performance
• □S 2.6 Assess and evaluate learners, teachers, and programs in an educationally appropriate manner

Professional

• □P 1.1 Intervene when behaviours toward learners undermine a respectful environment
• □P 3.3 Participate in the assessment of junior learners

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □Part A: ME 2.1 Identify and explore clinical issues to be addressed in the pre-analytical, analytical and post-analytical handling of a case
• □Part A: ME 5.1 Identify potential improvement opportunities arising from harmful patient safety incidents and near misses
• □Part B: ME 5.1 Recognize and respond to a breach in quality or safety of laboratory practices
• □Part B: ME 5.1 Resolve issues related to specimen misidentification and diagnostic or other errors
• □Part B: ME 5.1 Take appropriate actions to address a breach in quality or safety

Communicator

• □Part A: COM 3.2 Plan and document follow-up to a harmful patient safety incident
• □Part B: COM 3.2 Document actions taken to address a breach in quality or safety

Leader

• □Part A: L 1.1 Apply the science of quality improvement to contribute to improving systems of patient care
• □Part A: L 1.2 Contribute to a culture that promotes patient safety
• □Part A: L 1.4 Use health informatics to improve the quality of patient care and optimize patient safety
• □Part A: L 1.1 Participate in quality control, quality assurance and quality improvement initiatives
• □Part A: L 3.1 Demonstrate knowledge of the principles of laboratory management, including resource allocation and collaboration with technical managers, and hospital and laboratory administration

Health Advocate

• □Part A: HA 2.2 Improve clinical practice by applying a process of continuous quality improvement to disease prevention, health promotion, and health surveillance activities

Professional

• □Part A: P 2.2 Demonstrate a commitment to patient safety and quality improvement initiatives within their own practice environment
• □Part A: P 3.1 Fulfil and adhere to the professional and ethical codes, standards of practice, and laws governing practice
• □Part A: P 3.3 Explain the role of intra- and extra-departmental review of diagnostic material

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □ME 1.1 Demonstrate an awareness of what is required to practice safely and effectively in the setting of future practice

Leader

• □L 4.2 Examine personal interests and career goals
• □L 4.2 Adjust educational experiences to gain competencies necessary for future practice

Scholar

• □S 1.2 Interpret data on personal performance to identify opportunities for learning and improvement
• □S 1.1 Define learning needs related to personal practice and/or career goals
• □S 3.1 Generate focused questions that address practice uncertainty and knowledge gaps
• □S 1.1 Create a learning plan that is feasible, includes clear deliverables and a plan for monitoring ongoing achievement
• □S 1.1 Identify resources required to implement a personal learning plan

Professional

• □P 2.1 Demonstrate a commitment to maintaining and enhancing competence

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Setting

1. ●multidisciplinary rounds
2. ●direct communication with clinician
3. ●family conference
4. ●other

Test type(s)

1. ●in situ hybridization
2. ●PCR-based testing
3. ●cytogenetics
4. ●next-generation sequencing

Medical Expert

• □ME 2.2 Interpret the diagnostic, prognostic and treatment implications of molecular pathology test results
• □ME 2.4 Recommend additional genetic/non-genetic testing if required
• □ME 1.3 Apply knowledge of appropriate sample requirements and handling
• □ME 1.3 Apply knowledge of turnaround time and its importance for various genetic tests
• □ME 2.2 Select additional testing based on an appreciation of the diagnostic possibilities, the clinical context and the relevance and capabilities of available technologies
• □ME 4.1 Coordinate the use of multiple diagnostic investigations so as to ensure complementarity and efficiency

Communicator

• □COM 4.1 Incorporate the diagnostic, prognostic or predictive implications of molecular pathology tests into an integrated pathology report
• □COM 4.1 Include the recommended reporting elements, when integrating molecular results into an anatomic pathologic report

Collaborator

• □COL 1.3 Convey information to clinical colleagues in a manner that enhances patient management

Leader

• □L 2.1 Utilize genetic testing resources effectively to balance costs with potential utility of results

Scholar

• □S 3.4 Integrate best evidence and clinical expertise into decision making

Case description

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Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Observer role

1. ●pathologist
2. ●clinician
3. ●resident
4. ●other

Medical Expert

• □Part A: ME 1.4 Present and discuss pathology cases effectively at clinical rounds, in the role of a consultant in pathology
• □Part A: ME 1.6 Convey diagnostic uncertainty and recommend additional studies when needed
• □Part B: ME 1.5 Carry out professional duties in the face of multiple, competing demands
• □Part B: ME 1.6 Demonstrate insight into their own limits of expertise

Collaborator

• □Part A: COL 1.1 Establish positive relationships with other members of the health care team
• □Part A: COL 1.3 Convey information from the pathology assessment to clinicians in a manner that enhances patient management
• □Part A: COL 1.3 Support clinical colleagues in the development and implementation of a management plan, as appropriate
• □Part A: COL 2.2 Achieve consensus when there are differences in recommendations provided by other health care professionals
• □Part B: COL 1.1 Receive and respond appropriately to input from others
• □Part B: COL 1.3 Work effectively with physicians and other colleagues

Leader

• □Part B: L 1.1 Apply the science of quality improvement to contribute to improving systems of patient care
• □Part B: L 3.1 Demonstrate knowledge of the principles of laboratory management, including resource allocation and collaboration with technical managers, and hospital and laboratory administration
• □Part B: L 3.1 Demonstrate leadership skills to enhance health care
• □Part B: L 4.1 Set priorities and manage time to integrate practice and personal life

Scholar

• □Part A: S 3.4 Integrate best evidence and clinical expertise into decision-making
• □Part B: S 3.4 Integrate best evidence and clinical expertise into decision-making

Professional

• □Part A: P 1.1 Exhibit appropriate professional behaviours
• □Part B: P 2.1 Demonstrate a commitment to active participation in the activities of the profession
• □Part B: P 1.1 Exhibit appropriate professional behaviors

Case description

Feedback provided

Next steps