AMERICAN COLLEGE OF VETERINARY PATHOLOGISTS 2016 JOB TASK ANALYSIS FOR CLINICAL PATHOLOGY

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1 AMERICAN COLLEGE OF VETERINARY PATHOLOGISTS 206 JOB TASK ANALYSIS FOR CLINICAL PATHOLOGY Executive Summary This document describes the Job Task Analysis (JTA) conducted for Diplomates of the American College of Veterinary Pathologists (ACVP) in accordance with the requirements of the American Board of Veterinary Specialties and consistent with best practices for organizations that administer high stakes examinations. The JTA was composed of three phases: Invention, Refinement and Validation. The Invention Phase was conducted by the extended ACVP Certifying Examination Board (CEB) composed of core members appointed by Council and 9 ad hoc members representing ACVP committees and appointed positions with Certifying Examination (CE) related responsibilities. The objective of this phase was to produce a draft JTA document for subsequent levels of broader review. In the Refinement Phase, two panels, one for anatomic pathology (20 members) and one for clinical pathology (4 members) and representative of the demographics of the College, reviewed the draft documents and provided feedback to the CEB for refinement consideration. In the Validation Phase, the ACVP membership was asked to participate in an on-line survey asking for a -3 or 4 level agreement for each JTA draft task. Members were also asked to provide reasons for disagreements. Feedback from the survey was used to validate the conclusions of the first two phases of the JTA and to further refine the final document. The JTA culminated in the production of seven key tasks, five testable and two not testable, for each specialty. Also included in the first two phases of the JTA were CE blueprint categories species, organ system and process/topic to supplement the key tasks in mapping CE content. The final product is listed in Appendix X. Background The American Board of Veterinary Specialties (ABVS) requires that each constituent specialty college or board conduct a Job Task Analysis (JTA) at least every 0 years. The ABVS defines a JTA as follows: A systematic procedure for defining the tasks required by a job and the knowledge, skills, abilities, and other personal characteristics required of individuals performing that job. The results of a job/task analysis form the basis for determining the examination contents necessary to test mastery of that field. The ACVP conducted a (RDS) in , facilitated by Dr. Jim Henderson of Castle Worldwide. Results of this study were published in 2009 and are included as Appendix B. A test plan was developed based on that study and the Examination Committee (EC) mapped test items to the test plan beginning in 200. Successive ECs have revised the test plan to more accurately reflect exam content, while still adhering to the results of the RDS. The Certifying Examination Board (CEB) was formed in 20 and reviewed the test plan annually. In 202, the test plan was evaluated in depth and modified by a subcommittee of the CEB with the support of Dr. Henderson. The College s decision in 205 to redesign the Phase II Certifying Examination (CE), with implementation in 207, prompted the need to conduct a

2 new RDS. The CEB elected to use terminology Job Task Analysis (JTA) rather than RDS going forward as the former is consistent with the terminology used by the ABVS. In 205, the CEB, starting with the data and conclusions derived from the 2009 RDS, developed and approved the Scope of the ACVP Certifying Examination documents for the Phase II examination for anatomic and clinical pathology (Appendix B2). These documents defined the key tasks performed by entry-level veterinary pathologists engaged in both specialties. In March 206, the CEB finalized a plan for conducting the JTA, with an objective of completing the JTA and generating a CE content Blueprint for the 207 Phase II CE and the 208 Phase I examination by the 206 Annual Meeting. Although a Job/Task Analysis is a best practice for high stakes certifying examinations, there is no single method recommended for conducting this analysis (National Commission for Certifying Agencies Standards for the Accreditation of Certifying Programs, Standard 0). The CEB, with approval of ACVP Council, elected to conduct a JTA building on the data collected from the RDS, the experience gained by the EC and the CEB over the last 7 years working with the test plan based on that study, the current CE test plan matrix and the Scope of ACVP Certifying Examination documents. The CEB also recognized that the composition of the current examination, developed annually for over five decades by generations of Examination Committee members representative of the College at large, represents valuable historical data relative to CE content. Process Invention. This phase was conducted by the extended CEB composed of core members appointed by Council and 9 ad hoc members representing ACVP committees and appointed positions with CE-related responsibilities. The objective of this phase was to produce draft JTA documents for Anatomic and Clinical Pathology for subsequent levels of broader review. These documents included assigned percentages for: ) each of the testable Tasks identified in the original Scope of the ACVP Certifying Examination as needed for Ability at Entry anatomic and clinical pathologists and 2) Blueprint categories of species, organ system and process to be applied across all Tasks for each specialty. Members participating in this phase of exam, representing both Anatomic and Clinical Pathology, are listed in Appendix I.. The Invention Phase final draft JTA Tasks for Clinical Pathology are listed below. Detailed descriptions of the Tasks and the blueprint categories generated during the Invention Phase, including examination content proportions, are described in Appendix I.2. TASK : Identify, describe and interpret microscopic abnormalities in blood, bone marrow, body fluids, and tissues (cytology and histology) from domestic and nondomestic animals TASK 2: Recognize and interpret static visual test results pertinent to veterinary clinical pathology 2

3 TASK 3: Interpret and communicate clinicopathologic data from domestic and nondomestic animals TASK 4: Know the principles of commonly used laboratory instrumentation and methods TASK 5: Know pathophysiology and diagnosis of disease, with emphasis on manifestation in laboratory test data TASK 6: Demonstrate knowledge of the basic mechanisms of disease NON-TESTABLE TASKS TASK 7 Compose and communicate interpretation and significance of results TASK 8 Know and Understand Quality Assurance Refinement. In this phase, a panel composed of 4 Clinical Pathologists representative of the demographics of the College reviewed the draft JTA tasks and provided feedback to the CEB for refinement consideration. Members of the panel, including their demographic information, are listed in Appendix R.. Demographic categories included time as a diplomate, employment sector, and PhD or no PhD. Members of the two panels were provided background information (Appendix R.2) and given the opportunity to discuss the draft JTA through two webinars hosted by CEB members. Panel members provided feedback via an on-line questionnaire (Appendix R.3). Complete results of the survey are included in Appendix R.4. As a result of feedback from the panelists, a number of changes were made to the tasks and blueprint categories. The most significant change was the addition of a 6th task covering the content of the Phase I, General Pathology Exam: Know the basic mechanisms of disease. Minor changes included addition of missing or clarifying item detail within some of the Tasks. This modified document (Appendix R.5) was then distributed to the membership for review and feedback (Validation Phase). Validation. In this phase, the ACVP membership was asked to participate in an on-line survey asking for a - 3 level agreement for essentiality of each task and a 4 level agreement for the proportion of each task on the certifying examination. Members were also asked to provide reasons for disagreements. Feedback from the survey was used to validate the conclusions of the first two phases of the JTA and to further refine the final document. All active and emeritus members were surveyed, numbering 354 clinical pathologists. 5 clinical pathologists responded to the survey, 32% if those surveyed. There was a good balance of respondents by employment sector and years of experience. 3

4 Employment sector Percent responding Academia Diagnostic laboratory Government 0.87 Industry.30 Other (zoo, conservation, consulting, etc.) 2.6 Year passed the certifying examination Percent responding or earlier Background information was provided to the membership, which included a description of the JTA published in the ACVP Newsletter (Appendix V-) and an distributed to the membership with the survey which included a link to the JTA draft document (Appendix V-2). The survey questionnaire is at Appendix V-3 and the survey results are at Appendix V-4. Responses to the membership survey are summarized: Q: Rate the extent to which an entry-level veterinary clinical pathologist should be able to perform a task. There was marked majority rating of Essential to Moderately Essential for all testable Tasks, with a rank ordering from most essential being: Tasks, 3, 5, 6, 2 and 4. Any responses not essential represented a marked minority. For non-testable Tasks there was strong agreement for Task 7 being essential. There was a mix of agreement for Task 8, proficiency in laboratory and quality management, being essential. Q2: Do you agree with the proposed proportion of tasks on the phase II examination? There were a number of comments related to the distribution of tasks in the examination. These tended to cancel each other out. Examples include some recommended increasing Task, while others recommended a decrease. These responses were from a small minority. Given that the majority supported the proposed distribution, no changes will be implemented in the proposed task distributions for the Phase II exam. Q3: Are there critical tasks for entry-level clinical pathologists omitted in this JTA? 80% of the respondents indicated no omitted critical tasks. 20% indicated critical tasks were omitted and provided a wide range of recommendations for modifying/adding to draft tasks. There were several comments regarding importance of quality assurance, laboratory management, quality management, ability to assess research literature and apply new knowledge, critical evaluation of literature, and communication skills across the clinical pathologist interface audience. Some of these are non-testable tasks and/or of questionable relationship to entry- 4

5 level skills/knowledge. The CEB/CE should consider clarifying what elements of QA are testable and included under Task 4, instrumentation principles. For example, principles of quality assurance and method validation are intended to be included in Task 4. Q4: Fraction of job roles in which microscopy consists of histologic interpretations. A high majority indicated little to no involvement in histology, with 0% (48% of respondents) and -0% (42% of respondents). Eight individuals responded in the -25% of microscopy category. A small number indicated greater than 26% to a majority of their microscopy consisted of histologic interpretation. The few that practice a majority of microscopy involving histology have likely evolved a job role that bridges both clinical and anatomical pathology microscopy skills. A few spontaneous comments were mixed on the importance of histology for entry-level clinical pathologists. Q5: Utilization of Digital Microscopy The majority (69%) indicated 0% use of digital microscopy. This is appropriate for the current state of technology in most clinical pathology microscopy settings. About 30% of respondents indicated utilization between and 25% of microscopic interpretations, with most of these being in the -0% category. Two individuals indicated >50% of their microscopy is digital. It is possible that those using digital microscopy have evolved job roles that involve various fractions of histopathology, as suggested by responses to Q4. Q6: Concerns/Suggestions for the CEB related to the JTA. About half of the comments indicated None or provided positive feedback regarding the exam evolution process. There was a scattering of a few individual comments. Examples include a measure to test quality management and representation of toxicologic pathology. A couple of comments expressed lack of understanding of the JTA process. A couple of comments suggested that esoteric test items should be avoided both from literature and in practical recognition skills. As part of the examination re-design effort, both the CEB and EC have agreed to a set of test item development guidelines that address this concern. These guidelines are outlined in the document titled Principles of ACVP Examination Content Development (Anatomic and Clinical Pathology). This document is posted on the ACVP website. Membership Survey (Validation): Conclusions There was good agreement with the essentiality of all tasks. There was also good agreement on the distribution of tasks proposed to be examined in the Phase II examination. Comments on distribution of tasks in the proposed examination structure typically cancelled each other out; in other words, for a minority recommended shift in distribution in one direction, there was typically a corresponding minority shift in distribution in the opposite direction. These minority 5

6 responses appeared related to either unique employment experiences and/or unique perspectives, or on a failure to review the provided background information. Based on the responses, the membership survey validated the invention and refinement JTA proposal for Tasks and distribution of Tasks in the Phase II examination. Although the survey clearly confirmed that a high majority of veterinary clinical pathologists have little to no involvement with histopathology, it was the consensus of the CEB that exposure to histopathologic changes in commonly sampled tissues/lesions enhances one s understanding of lesion biology and cytologic sample manifestations. The ability of an entrylevel clinical pathologist to perform histopathologic evaluations, as addressed in this survey question, is a different question. The CEB will need to further address the role of histology skill in the Clinical Pathology certifying examination. Likewise, the role of digital slide scanning in the clinical pathologist JTA requires monitoring over time. Digital slide scanning at this point in time is more adaptable to histopathology. For cytopathology samples, digital slide scanning is currently typically not appropriate in most diagnostic settings given the limitations of current slide scanning protocols. Final Product. The final critical tasks and blueprint categories for Clinical Pathology, listed below and in Appendix X, were approved by majority vote of the CEB and submitted to ACVP Council on [date] for final approval. TASK : Identify, describe and interpret microscopic abnormalities in blood, bone marrow, body fluids, and tissues (cytology and histology) from domestic and non-domestic animals Tested via glass slides and image-based multiple choice questions (MCQs) ~30% of Phase II Skills and knowledge to: Write a coherent, organized descriptive report Write a concise summary relative to the descriptive findings Write an interpretive conclusion(s) and/or diagnosis(es) List appropriate disease(s), condition(s), and/or differential diagnoses List potential causes(s) Describe associated changes in other organ(s) Outline appropriate ancillary tests and anticipated results (e.g. special stains, immunohistochemistry, electron microscopy, PCR-based clonality, flow cytometry, cytology, other specialized laboratory tests in realms of biochemistry, serology, microbiology, immunodiagnostics) TASK 2: Recognize and interpret static visual test results pertinent to veterinary clinical pathology Tested via image-based MCQs ~0% of Phase II 6

7 Skills and knowledge for interpretation of: Hematology cytograms Flow cytometry plots Coagulation tracings Platelet aggregation plots Macroscopic hematology test results (eg. Coombs tests) Gross appearance of submitted samples Special and immunochemical stains Electron micrographs Quality assurance and quality control data Protein electrophoretograms and immunofixation reactions PCR clonality results TASK 3: Interpret and communicate clinicopathologic data from domestic and non-domestic animals Tested via case essays and MCQs ~30% of Phase II Skills and knowledge to: Describe pathophysiology of conditions leading to laboratory abnormalities Integrate laboratory abnormalities into a diagnosis (or differential diagnoses) Recommend appropriate ancillary tests to further confirm definitive or differential diagnoses Interpret population laboratory data or study set data Interpret integrated laboratory results (biochemistry, urinalysis, serology, microbiology, serum protein electrophoresis, immunodiagnostics, coagulation, hematology, etc.) TASK 4: Apply the principles of commonly used laboratory instrumentation and methods Tested via non-image based MCQs ~0% of Phase II Using knowledge to: Describe analyzer and test procedure methodologies List sample types and collection methods Describe procedures for reference interval determination List errors and interferences (pre-analytical, analytic and post-analytical) Define test properties (sensitivity, specificity, predictive values, ROC, etc.) and selection Describe quality control, quality assurance, relevant statistics Describe procedures for reference interval and method validation principles Describe routine, special and immunochemical stains Describe principles of light microscopy List the rules and regulations for laboratory safety and biosafety 7

8 TASK 5: Apply knowledge of the pathophysiology and diagnosis of disease, with emphasis on manifestation in laboratory test data Tested via non-image based MCQs ~20% of Phase II Using knowledge of pathogenesis, etiology and organ-based causes to answer questions concerning the following disease processes: Genetic alteration Disturbance of growth/neoplasia Cell aging/degeneration/injury/death Infection/immunity/inflammation Metabolic/nutritional/deficiency Hemodynamic/vascular disease TASK 6 Demonstrate knowledge of the basic mechanisms of disease Tested via non-image based MCQs 00% of Phase I (See Phase I Topic Distribution below) Using knowledge of: Mechanisms fundamental to disease in animals, including principles of: o Cellular injury o Inflammation and repair o Hemodynamic disorders o Physical and chemical injury o Neoplasia o Congenital and genetic diseases o Molecular pathology o Infectious processes o Immunology Mechanisms are general in nature in that they relate to most animal species NON-TESTABLE TASKS TASK 7 Compose and communicate interpretation and significance of results 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. 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). TASK 8 Demonstrate proficiency in laboratory management and quality practices Define standard operating procedures in accordance with prescribed methods in order to ensure acceptable levels of quality and consistency. 8

9 Evaluate specimens, reagents, instruments, and personnel training by inspection, review and documentation in order to ensure the validity of data. Evaluate data for evidence of pre-analytical and analytical error through inspection in order to determine if verification and troubleshooting are required to obtain reliable results. Demonstrate overall laboratory management aptitude Phase II Blueprint Category Targets Distribution by Species (Phase II) S Domestic 70 85% S2 Lab animal 0 5% S3 Non-domestic 5 0% Distribution by Organ system (Phase II) O Hemolymphatic, including coagulation 20 25% O2 Skin/Integument 6 2% O3 Cardiovascular 2 4% O4 Gastrointestinal 2 6% O5 Pancreas, exocrine 2 6% O6 Liver 2 5% O7 Endocrine 8 2% O8 Renal, including urinalysis and urinary tract 5 20% O9 Respiratory 2 6% O0 Nervous and special senses 2 4% O Musculoskeletal 2 6% O2 O3 O4 Reproductive Multiorgan/Systemic/Other Non-organ based* 2 4% 2 6% 0 20% *Defined as mostly principles of laboratory technology, from selected items in Tasks 2 and 4. Distribution by topic (Phase II) C Genetic 5 0% C2 Disturbance of growth/neoplasia 20 30% C3 Cell aging/degeneration/injury/death ~5% C4 Infection/immunity/inflammation 25 35% C5 Metabolic/including endocrinopathy, acid base, 0 5% abnormal biochemistry C6 Hemodynamic/vascular disease ~5% C7 Laboratory technology/analysis 5 20% 9

10 Phase I (General Pathology Blueprint) Distribution by topic (Phase I Examination targets, same for both Anatomical and Clinical Pathology) C Genetic 5 0% C2 Disturbance of growth/neoplasia 5 25% C3 Cell aging/degeneration/injury/death 5 5% C4 Infection/immunity/inflammation 35 55% C5 Metabolic/nutritional/deficiency 5 0% C6 Hemodynamic/vascular disease 5 0% C7 Laboratory technology/analysis 3 5% 0

11 Appendix Table of Contents Appendix Title Page(s) B B2 Scope of the ACVP Certifying Examination Clinical Pathology 52 I Invention Phase Panel Participants 53 I2 Invention Phase Draft JTA Tasks 54-6 R Refinement Phase Panel Participants 62 R2 Refinement Phase Background Information R3 Refinement Phase Questionnaire R4 Refinement Phase Survey Results R5 Modified Task and Blueprint Document V ACVP Newsletter JTA Description 90-9 V2 to ACVP Membership Describing Survey V3 Validation Phase Questionnaire V4 Validation Phase Survey Results X Task and Blueprint Lists 2-24

12 B 2009 American College of Veterinary Pathologists for the Veterinary Anatomic Pathologist and the Veterinary Clinical Pathologist REPORT 2

13 B 2009 Table of Contents Executive Summary...4 Introduction...5 Initial Development and Evaluation...7 Validation Study...0 Questionnaire Design, Sampling Plan, and Distribution...0 Who Responded to the Survey?...0 Validation of Veterinary Anatomic Pathologists Role...2 Anatomic Elements of Practice...2 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 ( ) American College of Veterinary Pathologists 2 3

14 B 2009 Background Executive Summary 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 () 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, 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 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 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 American College of Veterinary Pathologists 3 4

15 B 2009 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 73 of 237 anatomic pathology diplomates and 33 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 ( ) 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 ( 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:. 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 ( American College of Veterinary Pathologists 4 5

16 B 2009 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, 999). 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. American College of Veterinary Pathologists 5 6

17 B 2009 II. III. 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. 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 American College of Veterinary Pathologists 6 7

18 B 2009 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 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 postveterinary 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 American College of Veterinary Pathologists 7 8

19 B 2009 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 American College of Veterinary Pathologists 8 9

20 B 2009 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 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 Foundational Sciences: Anatomy and Physiology Biology Physical Sciences Applied Mathematics and Statistics Medicine Pathology Microbiology and Infectious Disease Veterinary Clinical Pathology 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 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. American College of Veterinary Pathologists 9 20

21 B 2009 I. Questionnaire Design and Distribution VALIDATION STUDY 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,468 diplomates (,202 anatomic, 23 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 ed 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 74 response records from veterinary anatomic pathologists and 33 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 and Figures 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. American College of Veterinary Pathologists 0 2

22 B 2009 Table : Degrees Earned * Degree Anatomic Clinical Frequency Percent Frequency Percent DVM/VMD (or equivalent) PhD MBA MPH Other Master s Other General * NOTE: Respondents could select more than one degree, so it is not reasonable to add the frequency or percent information. Figure : Degrees Earned Veterinary Anatomic Pathologists FREQUENCY DVM/VMD PhD MBA MPH Other Master's 72 Other General American College of Veterinary Pathologists 22

23 B 2009 Figure 2: Degrees Earned Veterinary Clinical Pathologists FREQUENCY DVM/VMD PhD MBA MPH Other Master's Other General 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. American College of Veterinary Pathologists 2 23

24 B 2009 Table 2: Year ACVP Certification Earned Year Anatomic Clinical Frequency Percent Frequency Percent No Response Total American College of Veterinary Pathologists 3 24

25 B 2009 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* Certification Anatomic Clinical Frequency Percent Frequency Percent ABVP ABVT ACLAM ACPV ACTHERIO ACVA ACVB ACVCP ACVD ACVECC ACVIM ACVM ACVN ACVO ACVPM ACVR ACVS ACZM AVDC ABTOX ECVP ECVCP One Certification Not Listed Two Certifications Not Listed * 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) = 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) American College of Veterinary Pathologists 4 25

26 B 2009 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 Standard Standard N Mean Deviation N Mean Deviation Birds Cats Cows Dogs Fish Horses Marine Mammals Non-Human Primates Pigs Pocket Pets Poultry Rabbits Reptiles and Amphibians Rodents Small Ruminants Wildlife Zoo Animals Veterinary pathologists practice in diverse settings. The largest group of veterinary anatomic respondents practices in industry (363, of whom 29 work full time in industry), most frequently in the pharmaceutical sector (208, of whom 46 work full time in the pharmaceutical industry). An essentially equivalent group of veterinary anatomic respondents works in academic settings (35, of whom 4 work full time in academics). Veterinary clinical respondents work most frequently in academic settings (8, 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 = 74 for anatomic and n = 33 for clinical). American College of Veterinary Pathologists 5 26

27 B 2009 Table 5a: Practice Setting Frequency * Practice Setting Anatomic Clinical Frequency Percent Frequency Percent Academic Teaching Research Clinical Administration Diagnostic Government Industry Chemical Pharmaceutical Biotechnology Contract Medical Devices Research Private Practice Non-practicing Other * 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. American College of Veterinary Pathologists 6 27

28 B 2009 Table 5b: Descriptive Statistics for Percentage of Work Week in Practice Areas Anatomic Clinical Practice Settings Standard Standard N Mean Deviation N Mean Deviation Academic Teaching Research Clinical Administration Diagnostic Government Industry Chemical Pharmaceutical Biotechnology Contract Medical Devices Research Private Practice Non-practicing Other 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 3.7% of their time in that role. Fewer respondents, but still more than half (5.%), 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 Response Anatomic Clinical Frequency Percent Frequency Percent Yes No No Response Total 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 American College of Veterinary Pathologists 7 28

29 B 2009 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 5. 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 2.0 percent of their time in these areas. Table 8: Respondents Involved in Training Veterinary Pathologists for Board Eligibility Response Anatomic Clinical Frequency Percent Frequency Percent Yes No No Response Total 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 The vast majority of respondents from both specialties report working full time, as shown in Table 0. Ten veterinary anatomic respondents reported being retired, even though retired members of ACVP were not included when the survey was distributed. Table 0: Full and Part Time Work Status Response Anatomic Clinical Frequency Percent Frequency Percent Yes No Retired No Response Total 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. American College of Veterinary Pathologists 8 29

30 B 2009 Table : Percent of Time Spent Practicing Veterinary Pathology Anatomic Clinical Frequenc Frequenc Mean Std Dev y y Mean Std Dev Time Spent Respondents were asked to indicate the state, province, or international region in which they practice. This information is reported in Table 2. It is clear that veterinary pathologists are distributed reasonably, although there are concentrations in major research centers. American College of Veterinary Pathologists 9 30

31 B 2009 Table 2: Primary State, Province, or International Region Location Anatomic Clinical Frequency Percent Frequency Percent USA Alaska Arkansas Alabama Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania South Carolina South Dakota Tennessee Texas Utah Virginia Washington American College of Veterinary Pathologists 20 3

32 B 2009 Table 2 (Continued): Primary State, Province, or International Region Location Anatomic Clinical Frequency Percent Frequency Percent USA Wisconsin West Virginia Wyoming Canada Alberta British Columbia Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan International Regions Africa Asia/Pacific Islands Australia Europe No Response Total 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 3. 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 3: Gender Response Anatomic Clinical Frequency Percent Frequency Percent Male Female No Response Total Anatomic Elements of Practice Validation of Veterinary Anatomic Pathologists Role 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. American College of Veterinary Pathologists 2 32

33 B 2009 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. = Expected of new diplomates. 2 = Acquired after board certification is earned. Table 4 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 3, 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. American College of Veterinary Pathologists 22 33

34 B 2009 Table 4: Point of Acquisition for Anatomic Elements of Practice Elements of Practice: Point of Acquisition Scale I. Research and Investigative II. III. IV. Rating Count Percent Design Data Collection Data Analysis and Interpretation Communication and Reporting V. Quality Assurance VI. Public Health and Risk Management VII. Education and Professional Development Ratings: 0 = not applicable, = 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. American College of Veterinary Pathologists 23 34

35 B = 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. = 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 5: Criticality of Anatomic Elements of Practice Element of Practice Mean Dev. N SEM I. Research and Investigative Design II. Data Collection III. Data Analysis and Interpretation IV. Communication and Reporting V. Quality Assurance VI. Public Health and Risk Management VII. Education and Professional Development Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 24 35

36 B 2009 Figure 3: Mean Criticality by Anatomic Element of Practice 4 RATING EP I EP II EP III EP IV EP V EP VI EP VI 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. = 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 American College of Veterinary Pathologists 25 36

37 B 2009 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 6: Frequency of Anatomic Elements of Practice Element of Practice Mean Dev. N SEM I. Research and Investigative Design II. Data Collection III. Data Analysis and Interpretation IV. Communication and Reporting V. Quality Assurance VI. Public Health and Risk Management VII. Education and Professional Development Ratings: 0 = Never, = 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 RATING EP I EP II EP III EP IV EP V EP VI EP VII 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. American College of Veterinary Pathologists 26 37

38 B 2009 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 7: 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 Rating Count Percent Design experiments and diagnostic investigations Coordinate research and diagnostic investigations Develop investigational techniques Use animal models of disease Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned Table 8: Criticality of Tasks Within Anatomic Element of Practice I (Research and Investigative Design) Tasks Within Element of Practice I N Mean SEM Dev. Design experiments and diagnostic investigations Coordinate research and diagnostic investigations Develop investigational techniques Use animal models of disease Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 27 38

39 B 2009 Table 9: Frequency of Tasks Within Anatomic Element of Practice I (Research and Investigative Design) Tasks Within Element of Practice I N Mean SEM Dev. Design experiments and diagnostic investigations Coordinate research and diagnostic investigations Develop investigational techniques Use animal models of disease Ratings: 0 = Never, = 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. American College of Veterinary Pathologists 28 39

40 B 2009 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 Rating Count Percent Review antemortem data and history to collect relevant samples Guide sample collection by others Perform necropsies Collect gross morphometric data Collect specimens to preserve sample integrity Describe morphological observations Photograph gross and microscopic observations Select applicable assays Perform microscopic, morphometric, analyses, quantitative interpretations Perform critical reviews of literature and data Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 29 40

41 B 2009 Table 2: Criticality of Tasks Within Anatomic Element of Practice II (Data Collection) Tasks Within Element of Practice II N Mean SEM Dev. Review antemortem data and history to collect relevant samples Guide sample collection by others Perform necropsies Collect gross morphometric data Collect specimens to preserve sample integrity Describe morphological observations Photograph gross and microscopic observations Select applicable assays Perform microscopic, morphometric analyses, quantitative interpretations Perform critical reviews of literature and data Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 22: Frequency of Tasks Within Anatomic Element of Practice II (Data Collection) Tasks Within Element of Practice II N Mean SEM Dev. Review antemortem data and history to collect relevant samples Guide sample collection by others Perform necropsies Collect gross morphometric data Collect specimens to preserve sample integrity Describe morphological observations Photograph gross and microscopic observations Select applicable assays Perform microscopic, morphometric analyses, quantitative interpretations Perform critical reviews of literature and data Ratings: 0 = Never, = 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. American College of Veterinary Pathologists 30 4

42 B 2009 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. American College of Veterinary Pathologists 3 42

43 B 2009 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 Rating Count Percent Evaluate tissue morphology Use special microscopic techniques Interpret immunohistochemistry, histochem-istry, in situ immuno-chemistry and hybridization Interpret advanced tissuebased cellular and molecular biology data Integrate pathologic and epidemiological findings Integrate individual animal data Interpret normal variations and spontaneous findings Identify artifacts in tissue sections and other samples Organize complete data sets for study analysis Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 32 43

44 B 2009 Table 24: Criticality of Tasks Within Anatomic Element of Practice III (Data Analysis and Interpretation) Tasks Within Element of Practice III Dev. N Mean SEM Evaluate tissue morphology Use special microscopic techniques Interpret immunohistochemistry, histochemistry, in situ immunochemistry and hybridization Interpret advanced tissue-based cellular and molecular biology data Integrate pathologic and epidemiological findings Integrate individual animal data Interpret normal variations and spontaneous findings Identify artifacts in tissue sections and other samples Organize complete data sets for study analysis Ratings: 0 = No harm or not applicable, = 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) Tasks Within Element of Practice III Dev. N Mean SEM Evaluate tissue morphology Use special microscopic techniques Interpret immunohistochemistry, histochemistry, in situ immunochemistry and hybridization Interpret advanced tissue-based cellular and molecular biology data Integrate pathologic and epidemiological findings Integrate individual animal data Interpret normal variations and spontaneous findings Identify artifacts in tissue sections and other samples Organize complete data sets for study analysis Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 33 44

45 B 2009 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 Rating Count Percent Communicate pathology findings and their significance to clinicians, regulators, and scientists Communicate animal disease to the public Discuss scientific findings in public forums to educate stakeholders Publish scientific findings in peer reviewed literature Disseminate knowledge through publications, abstracts, reports, and presentations, Testify as an expert witness or as the pathologist of record Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 34 45

46 B 2009 Table 27: Criticality of Tasks Within Anatomic Element of Practice IV (Communication and Reporting) Tasks Within Element of Practice IV N Mean SEM Dev. Communicate pathology findings and their significance to clinicians, regulators, and scientists Communicate animal disease to the public Discuss scientific findings in public forums to educate stakeholders Publish scientific findings in peer reviewed literature Disseminate knowledge through publications, abstracts, reports, and presentations Testify as an expert witness or as the pathologist of record Ratings: 0 = No harm or not applicable, = 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) Tasks Within Element of Practice IV N Mean SEM Dev. Communicate pathology findings and their significance to clinicians, regulators, and scientists Communicate animal disease to the public Discuss scientific findings in public forums to educate stakeholders Publish scientific findings in peer reviewed literature Disseminate knowledge through publications, abstracts, reports, and presentations Testify as an expert witness or as the pathologist of record Ratings: 0 = Never, = 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. American College of Veterinary Pathologists 35 46

47 B 2009 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 Rating Count Percent Conduct reviews of designs, proposals, results, and manuscripts Supervise technical staff Conduct pathology peer review Resolve discrepancies using pathology working groups and external experts Provide results in accordance with SOPs or scientific principles Author standard operating procedures Conduct laboratory inspections Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 36 47

48 B 2009 Table 30: Criticality of Tasks Within Anatomic Element of Practice V (Quality Assurance) Tasks Within Element of Practice V N Mean SEM Dev. Conduct reviews of designs, proposals, results, and manuscripts Supervise technical staff Conduct pathology peer review Resolve discrepancies using pathology working groups and external experts Provide results in accordance with SOPs or scientific principles Author standard operating procedures Conduct laboratory inspections Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 3: Frequency of Tasks Within Anatomic Element of Practice V (Quality Assurance) Tasks Within Element of Practice V N Mean SEM Dev. Conduct reviews of designs, proposals, results, and manuscripts Supervise technical staff Conduct pathology peer review Resolve discrepancies using pathology working groups and external experts Provide results in accordance with SOPs or scientific principles Author standard operating procedures Conduct laboratory inspections Ratings: 0 = Never, = 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. American College of Veterinary Pathologists 37 48

49 B 2009 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 Rating Count Percent Monitor disease trends using databases and networking Recognize novel manifestations of disease Train others to detect disease threats Detect diseases that threaten public or animal health Report disease occurrence Develop rational disease mitigation strategy Characterize responses in animals to provide risk assessment Integrate animal disease and population management information to improve risk assessment Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 38 49

50 B 2009 Table 33: Criticality of Tasks Within Anatomic Element of Practice VI (Public Health and Risk Management) Tasks Within Element of Practice VI N Mean SEM Dev. Monitor disease trends using databases and networking Recognize novel manifestations of disease Train others to detect disease threats Detect diseases that threaten public or animal health Report disease occurrence Develop rational disease mitigation strategy Characterize responses in animals to provide risk assessment Integrate animal disease and population management information with animal population management Ratings: 0 = No harm or not applicable, = 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) Tasks Within Element of Practice VI N Mean SEM Dev. Monitor disease trends using databases and networking Recognize novel manifestations of disease Train others to detect disease threats Detect diseases that threaten public or animal health Report disease occurrence Develop rational disease mitigation strategy Characterize responses in animals to provide risk assessment Integrate animal disease and population management information with animal population management Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 39 50

51 B 2009 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. American College of Veterinary Pathologists 40 5

52 B 2009 Table 35: Point of Acquisition for Tasks Within Anatomic Element of Practice VII (Education and Professional Development) Tasks Within Element of Practice VI: Point of Acquisition Scale Rating Count Percent Conduct reviews of designs, proposals, results, and manuscripts Educate regulators, other scientists, and officials Serve as an expert consultant Instruct professionals to advance the discipline of pathology Promote personal and professional development Mentor others regarding organizations and career opportunities Train others in veterinary pathology to impart technical proficiency Train personnel in safe specimen handling Serve on professional and scientific committees Model the responsible conduct of research Mentor graduate students and postdoctoral trainees in research Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 4 52

53 B 2009 Table 36: Criticality of Tasks Within Anatomic Element of Practice VII (Education and Professional Development) Tasks Within Element of Practice VII N Mean SEM Dev. Conduct reviews of designs, proposals, results, and manuscripts Educate regulators, other scientists, and officials Serve as an expert consultant Instruct professionals to advance the discipline of pathology Promote personal and professional development Mentor others regarding organizations and career opportunities Train others in veterinary pathology to impart technical proficiency Train personnel in safe specimen handling Serve on professional and scientific committees Model the responsible conduct of research Mentor graduate students and postdoctoral trainees in research Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 42 53

54 B 2009 Table 37: Frequency of Tasks Within Anatomic Element of Practice VII (Education and Professional Development) Tasks Within Element of Practice VII N Mean SEM Dev. Conduct reviews of designs, proposals, results, and manuscripts Educate regulators, other scientists, and officials Serve as an expert consultant Instruct professionals to advance the discipline of pathology Promote personal and professional development Mentor others regarding organizations and career opportunities Train others in veterinary pathology to impart technical proficiency Train personnel in safe specimen handling Serve on professional and scientific committees Model the responsible conduct of research Mentor graduate students and postdoctoral trainees in research Ratings: 0 = Never, = 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. American College of Veterinary Pathologists 43 54

55 B 2009 Table 38: Point of Acquisition for Anatomic Foundational Sciences Frequency Analysis for Foundational Sciences: Acquisition Scale Rating Frequency Percent Anatomy and Physiology Biology Physical Sciences Applied Mathematics and Statistics Medicine Pathology Microbiology and Infectious Disease Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned Table 39: Criticality of Anatomic Foundational Sciences Foundational Science Mean Dev. N SEM I. Anatomy and Physiology II. Biology III. Physical Sciences IV. Applied Mathematics and Statistics V. Medicine VI. Pathology VII. Microbiology and Infectious Disease Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 44 55

56 B 2009 Figure 5: Mean Criticality by Anatomic Foundational Science RATING FS I FS II FS III FS IV FS V FS VI FS VII Table 40: Frequency of Anatomic Foundational Sciences Foundational Sciences Mean Dev. N SEM I. Anatomy and Physiology II. Biology III. Physical Sciences IV. Applied Mathematics and Statistics V. Medicine VI. Pathology VII. Microbiology and Infectious Disease Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 45 56

57 B 2009 Figure 6: Mean Frequency by Anatomic Foundational Science RATING FS I FS II FS III FS IV FS V FS VI FS VII 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 4: Criticality of Specific Sciences in Anatomic Foundational Science I: Anatomy and Physiology Specific Sciences N Mean SEM Dev. Macroscopic Anatomy Microscopic Anatomy Histology Cytology Ultrastructure Physiology Immunology Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 46 57

58 B 2009 Table 4: Criticality of Specific Sciences in Anatomic Foundational Science II: Biology Specific Sciences N Mean SEM Dev. Zoology Cell and Molecular Biology Developmental Biology Genetics Ecology Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 42: Criticality of Specific Sciences in Anatomic Foundational Science III: Physical Sciences Specific Sciences N Mean SEM Dev. Biochemistry Organic Chemistry Inorganic Chemistry Physics Ratings: 0 = No harm or not applicable, = 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 Specific Sciences N Mean SEM Dev. Biostatistics Bioinformatics Epidemiology Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 44: Criticality of Specific Sciences in Anatomic Foundational Science V: Medicine Specific Sciences N Mean SEM Dev. Pharmacology Toxicology Diagnostic Imaging Comparative Medicine Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 47 58

59 B 2009 Table 45: Criticality of Specific Sciences in Anatomic Foundational Science VI: Pathology Specific Sciences N Mean SEM Dev. General Pathology Systemic Pathology Clinical Pathology Cell and Molecular Pathology Ratings: 0 = No harm or not applicable, = 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 Specific Sciences N Mean SEM Dev. Virology Bacteriology Mycology Parasitology Ratings: 0 = No harm or not applicable, = 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 Rating Frequency Percent Histology/Cytology Light Microscopy (Standard HE) Cytology (standard Wright-Giemsa) Histochemistry/ Cytochemistry (Special Stains) Immunohistochemistry /Immunocytochemistry In Situ Hybridization Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 48 59

60 B 2009 Table 47 (Continued): Point of Acquisition for Anatomic Tools Frequency Analysis for Tools: Acquisition Scale Rating Frequency Percent Photomicroscopy Clinical Pathology Clinical Chemistry Interpretation Hematology Interpretation Urinalysis Interpretation Clinical Chemistry Analyzers Hematology Analyzers Coagulation Analyzers Blood Gas Analyzers Immunoassay Analyzers Special Microscopy Techniques Fluorescence Microscopy Transmission Electron Microscopy Immunoelectron Microscopy Scanning Electron Microscopy Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 49 60

61 B 2009 Table 47 (Continued): Point of Acquisition for Anatomic Tools Frequency Analysis for Tools: Acquisition Scale Rating Frequency Percent Confocal Microscopy Computer-Aided Slide Analysis Intravital Microscopy Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) Computer-Based Image Analysis Computer Modeling of Biological System/ Organisms/Organs Flow Cytometry Laser Capture Microdissection Spectrophotometry Cell Culture Telepathology In Vivo Imaging (e.g., bioluminescence) Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 50 6

62 B 2009 Table 47 (Continued): Point of Acquisition for Anatomic Tools Frequency Analysis for Tools: Acquisition Scale Rating Frequency Percent Biochemical and Molecular Techniques/Tools PCR and Related Molecular Techniques Gene Microarray Protein Microarray Tissue Microarray Gene Regulation/ Mutagenesis Western Blotting and Related Proteomic Techniques FISH/Cytogenetics Immunoassays (Radio immunodiffusion Assays, ELISA, etc.) ph Assays Electrophoresis Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 5 62

63 B 2009 Table 48: Criticality of Anatomic Tools Tools N Mean SEM Dev. Histology/Cytology Light Microscopy (Standard HE) Cytology (standard Wright-Giemsa) Histochemistry/Cytochemistry (Special Stains) Immunohistochemistry/Immunocytochemistry In Situ Hybridization Photomicroscopy Clinical Pathology Clinical Chemistry Interpretation Hematology Interpretation Urinalysis Interpretation Clinical Chemistry Analyzers Hematology Analyzers Coagulation Analyzers Blood Gas Analyzers Immunoassay Analyzers Special Microscopy Techniques Fluorescence Microscopy Transmission Electron Microscopy Immunoelectron Microscopy Scanning Electron Microscopy Confocal Microscopy Computer-Aided Slide Analysis Intravital Microscopy Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) Computer-Based Image Analysis Computer Modeling of Biological System/ Organisms/Organs Flow Cytometry Laser Capture Microdissection Spectrophotometry Cell Culture Telepathology In Vivo Imaging (e.g., bioluminescence) Biochemical and Molecular Techniques/ Tools PCR and Related Molecular Techniques Gene Microarray Protein Microarray Tissue Microarray Gene Regulation/Mutagenesis Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 52 63

64 B 2009 Table 48 (Continued): Criticality of Anatomic Tools Tools N Mean SEM Dev. Western Blotting and Related Proteomic Techniques FISH/Cytogenetics Immunoassays (Radioimmunodiffusion Assays, ELISA, etc.) ph Assays Electrophoresis Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 49: Frequency of Anatomic Tools Tools N Mean SEM Dev. Histology/Cytology Light Microscopy Standard HE Cytology (standard Wright-Giemsa) Histochemistry/Cytochemistry(Special Stains) Immunohistochemistry/Immunocytochemistry In Situ Hybridization Photomicroscopy Clinical Pathology Clinical Chemistry Interpretation Hematology Interpretation Urinalysis Interpretation Clinical Chemistry Analyzers Hematology Analyzers Coagulation Analyzers Blood Gas Analyzers Immunoassay Analyzers Special Microscopy Techniques Fluorescence Microscopy Transmission Electron Microscopy Immunoelectron Microscopy Scanning Electron Microscopy Confocal Microscopy Computer-Aided Slide Analysis Intravital Microscopy Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 53 64

65 B 2009 Table 49 (Continued): Frequency of Anatomic Tools Tools N Mean SEM Dev. Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) Computer-Based Image Analysis Computer Modeling of Biological System/ Organisms/Organs Flow Cytometry Laser Capture Microdissection Spectrophotometry Cell Culture Telepathology In Vivo Imaging (e.g., bioluminescence) Biochemical and Molecular Techniques/ Tools PCR and Related Molecular Techniques Gene Microarray Protein Microarray Tissue Microarray Gene Regulation/Mutagenesis Western Blotting and Related Proteomic Techniques FISH/Cytogenetics Immunoassays (Radioimmunodiffusion Assays, ELISA, etc.) ph Assays Electrophoresis Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Clinical Elements of Practice Validation of Veterinary Clinical Pathologists Roles 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: American College of Veterinary Pathologists 54 65

66 B 2009 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. = 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 I. Research and Investigative II. III. IV. Rating Count Percent Design Data Collection, Analysis, and Interpretation Communication and Reporting Quality Assurance V. Public Health and Risk Management VI. Education and Professional Development Ratings: 0 = not applicable, = 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. American College of Veterinary Pathologists 55 66

67 B = 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. = 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 5: Criticality of Clinical Elements of Practice Element of Practice Mean Dev. N SEM I. Research and Investigative Design II. Data Collection, Analysis, and Interpretation III. Communication and Reports IV. Quality Assurance V. Public Health and Risk Management VI. Education and Professional Development Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 56 67

68 B 2009 Figure 7: Mean Criticality by Clinical Element of Practice RATING EP I EP II EP III EP IV EP V EP VI 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. = 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, American College of Veterinary Pathologists 57 68

69 B 2009 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 Element of Practice Mean Dev. N SEM I. Research and Investigative Design II. Data Collection, Analysis, and Interpretation III. Communication and Reports IV. Quality Assurance V. Public Health and Risk Management VI. Education and Professional Development Ratings: 0 = Never, = 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 RATING EP I EP II EP III EP IV EP V EP VI 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. American College of Veterinary Pathologists 58 69

70 B 2009 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) Tasks Within Element of Practice I: Point of Acquisition Scale Rating Count Percent Gather technical and scientific information to optimize study results Contribute to the study design Instruct clinicians, technical staff, and other professionals in assay selection and sample collection Recommend ancillary or follow-up testing Independently construct a hypothesis-driven investigation Develop investigational techniques and assays in clinical pathology Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 59 70

71 B 2009 Table 54: Criticality of Tasks Within Clinical Element of Practice I (Research and Investigative Design) Tasks Within Element of Practice I N Mean SEM Dev. Gather technical and scientific information to optimize study results Contribute to the study design Instruct clinicians, technical staff, and other professionals in assay selection and sample collection Recommend ancillary or follow-up testing Independently construct a hypothesis-driven investigation Develop investigational techniques and assays in clinical pathology Ratings: 0 = No harm or not applicable, = 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) Tasks Within Element of Practice I N Mean SEM Dev. Gather technical and scientific information to optimize study results Contribute to the study design Instruct clinicians, technical staff, and other professionals in assay selection and sample collection Recommend ancillary or follow-up testing Independently construct a hypothesis-driven investigation Develop investigational techniques and assays in clinical pathology Ratings: 0 = Never, = 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. American College of Veterinary Pathologists 60 7

72 B 2009 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. American College of Veterinary Pathologists 6 72

73 B 2009 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 Rating Count Percent Understand the principles of current pathology instrumentation Collect samples using appropriate methods Direct the collection of samples Describe light and electron microscopic observations Interpret light and electron microscopic observations Describe hematological and hemostasis data Interpret hematological and hemostasis data Describe clinical chemistry data Interpret clinical chemistry data Describe data generated from the analysis of urine and other body fluids Interpret data generated from the analysis of urine and other body fluids Describe data generated from immunoassays Interpret data generated from immunoassays American College of Veterinary Pathologists 62 73

74 B 2009 Table 56 (Continued): 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 Rating Count Percent Utilize molecular methods and novel testing techniques Utilize specialized microscopic techniques Archive samples and/or related data Apply proper statistical tests Provide a contextual interpretation Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 63 74

75 B 2009 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 Dev. Understand the principles of current pathology instrumentation Collect samples using appropriate methods Direct the collection of samples Describe light and electron microscopic observations Interpret light and electron microscopic observations Describe hematological and hemostasis data Interpret hematological and hemostasis data Describe clinical chemistry data Interpret clinical chemistry data Describe data generated from the analysis of urine and other body fluids Interpret data generated from the analysis of urine and other body fluids Describe data generated from immunoassays Interpret data generated from immunoassays Utilize molecular methods and novel testing techniques Utilize specialized microscopic techniques Archive samples and/or related data Apply proper statistical tests Provide a contextual interpretation Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 64 75

76 B 2009 Table 58: Frequency of Tasks Within Clinical Element of Practice II (Data Collection, Analysis, and Interpretation) Tasks Within Element of Practice II N Mean SEM Dev. Understand the principles of current pathology instrumentation Collect samples using appropriate methods Direct the collection of samples Describe light and electron microscopic observations Interpret light and electron microscopic observations Describe hematological and hemostasis data Interpret hematological and hemostasis data Describe clinical chemistry data Interpret clinical chemistry data Describe data generated from the analysis of urine and other body fluids Interpret data generated from the analysis of urine and other body fluids Describe data generated from immunoassays Interpret data generated from immunoassays Utilize molecular methods and novel testing techniques Utilize specialized microscopic techniques Archive samples and/or related data Apply proper statistical tests Provide a contextual interpretation Ratings: 0 = Never, = 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. American College of Veterinary Pathologists 65 76

77 B 2009 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) Tasks Within Element of Practice III: Point of Acquisition Scale Rating Count Percent Write clinical pathology reports Author manuscripts Deliver scientific or technical presentations Communicate the significance of clinical pathology results Respond to formal inquiries from regulatory 6 3. agencies or other groups Communicate clinical pathology knowledge Ratings: 0 = not applicable, = 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) Tasks Within Element of Practice III N Mean SEM Dev. Write clinical pathology reports Author manuscripts Deliver scientific or technical presentations Communicate the significance of clinical pathology results Respond to formal inquiries from regulatory agencies or other groups Communicate clinical pathology knowledge Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 66 77

78 B 2009 Table 6: Frequency of Tasks Within Clinical Element of Practice III (Communication and Reporting) Tasks Within Element of Practice III N Mean SEM Dev. Write clinical pathology reports Author manuscripts Deliver scientific or technical presentations Communicate the significance of clinical pathology results Respond to formal inquiries from regulatory agencies or other groups Communicate clinical pathology knowledge Ratings: 0 = Never, = 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. American College of Veterinary Pathologists 67 78

79 B 2009 Table 62: Point of Acquisition for Tasks Within Clinical Element of Practice IV (Quality Assurance) Tasks Within Element of Practice IV: Point of Acquisition Scale Rating Count Percent Define standard operating procedures Evaluate specimens, reagents, instruments, and personnel training to ensure validity of data Evaluate data for evidence of preanalytical and analytical error Resolve quality assurance problems Develop and improve assays Conduct reviews of reports and manuscripts Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned Table 63: Criticality of Tasks Within Clinical Element of Practice IV (Quality Assurance) Tasks Within Element of Practice IV N Mean SEM Dev. Define standard operating procedures Evaluate specimens, reagents, instruments, and personnel training to ensure validity of data Evaluate data for evidence of preanalytical and analytical error Resolve quality assurance problems Develop and improve assays Conduct reviews of reports and manuscripts Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 68 79

80 B 2009 Table 64: Frequency of Tasks Within Clinical Element of Practice IV (Quality Assurance) Tasks Within Element of Practice IV N Mean SEM Dev. Define standard operating procedures Evaluate specimens, reagents, instruments, and personnel training to ensure validity of data Evaluate data for evidence of preanalytical and analytical error Resolve quality assurance problems Develop and improve assays Conduct reviews of reports and manuscripts Ratings: 0 = Never, = 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). American College of Veterinary Pathologists 69 80

81 B 2009 Table 65: Point of Acquisition for Tasks Within Clinical Element of Practice V (Public Health and Risk Management) Tasks Within Element of Practice V: Point of Acquisition Scale Rating Count Percent Design safe sample handling protocols for infectious and toxic agents Design protocols to manage chemicals and 2 8. laboratory waste Recognize the public health significance of infectious agents Design clinical pathology testing strategies for disease surveillance Integrate clinical and comparative pathology data to understand implications Ratings: 0 = not applicable, = 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) Tasks Within Element of Practice V N Mean SEM Dev. Design safe sample handling protocols for infectiousad toxic agents Design protocols to manage chemicals and laboratory waste Recognize the public health significance of infectious agents Design clinical pathology testing strategies for disease surveillance Integrate clinical pathology and comparative pathology data to understand implications Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 70 8

82 B 2009 Table 67: Frequency of Tasks Within Clinical Element of Practice V (Public Health and Risk Management) Tasks Within Element of Practice V N Mean SEM Dev. Design safe sample handling protocols for infectious and toxic agents Design protocols to manage chemicals and laboratory waste Recognize the public health significance of infectious agents Design clinical pathology testing strategies for disease surveillance Integrate clinical pathology and comparative pathology data to understand implications Ratings: 0 = Never, = 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. 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. American College of Veterinary Pathologists 7 82

83 B 2009 Table 68: Point of Acquisition for Tasks Within Clinical Element of Practice VI (Education and Professional Development) Tasks Within Element of Practice VI: Point of Acquisition Scale Rating Count Percent Instruct veterinary students Instruct veterinary pathology residents Provide continuing education and training Provide mentorship and guidance to trainees and colleagues Participate in professional development activities Provide education to the public in aspects of veterinary clinical pathology Serve on professional and scientific committees Ratings: 0 = not applicable, = 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) Tasks Within Element of Practice VI N Mean SEM Dev. Instruct veterinary students Instruct veterinary pathology residents Provide continuing education and training Provide mentorship and guidance to trainees and colleagues Participate in professional development activities Provide education to the public in aspects of veterinary clinical pathology Serve on professional and scientific committees Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 72 83

84 B 2009 Table 70: Frequency of Tasks Within Clinical Element of Practice VI (Education and Professional Development) Tasks Within Element of Practice VI N Mean SEM Dev. Instruct veterinary students Instruct veterinary pathology residents Provide continuing education and training Provide mentorship and guidance to trainees and colleagues Participate in professional development activities Provide education to the public in aspects of veterinary clinical pathology Serve on professional and scientific committees Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Clinical Foundational Sciences Table 7 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 7 that skill associated with all foundational sciences is expected when diplomates earn ACVP certification as veterinary clinical pathologists. Table 7: Point of Acquisition for Clinical Foundational Sciences Frequency Analysis for Foundational Sciences: Acquisition Scale Rating Frequency Percent Anatomy Applied Mathematics and Statistics Biology/Pathology Chemistry Microbiology Physiology/ Pathophysiology Physics Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 73 84

85 B 2009 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 Foundational Science Mean Dev. N SEM I. Anatomy II. Applied Mathematics and Statistics III. Biology/Pathology IV. Chemistry V. Microbiology VI. Physiology/Pathophysiology VII. Physics Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Figure 9: Mean Criticality by Clinical Foundational Science RATING FS I FS II FS III FS IV FS V FS VI FS VII American College of Veterinary Pathologists 74 85

86 B 2009 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 Mean Dev. N SEM I. Anatomy II. Applied Mathematics and Statistics III. Biology/Pathology IV. Chemistry V. Microbiology VI. Physiology/Pathophysiology VII. Physics Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Figure 0: Mean Frequency by Clinical Foundational Science RATING FS I FS II FS II FS IV FS V FS VI FS VII American College of Veterinary Pathologists 75 86

87 B 2009 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 Specific Sciences N Mean SEM Dev. Macroscopic Anatomy Microscopic Anatomy Histology Cytology Ultrastructural Anatomy Ratings: 0 = No harm or not applicable, = 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 Specific Sciences N Mean SEM Dev. Data Management Systems Biostatistics Bioinformatics Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 76: Criticality of Specific Sciences in Clinical Foundational Science III: Biology/Pathobiology Specific Sciences N Mean SEM Dev. Cell Biology Developmental Biology and Aging Genetics Immunology Molecular Biology Cancer Biology Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 76 87

88 B 2009 Table 77: Criticality of Specific Sciences in Clinical Foundational Science IV: Chemistry Specific Sciences N Mean SEM Dev. Biochemistry Clinical Chemistry Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 78: Criticality of Specific Sciences in Clinical Foundational Science V: Microbiology Specific Sciences N Mean SEM Dev. Mycology Virology Parasitology Bacteriology Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 79: Criticality of Specific Sciences in Clinical Foundational Science VI: Physiology/ Pathophysiology Specific Sciences N Mean SEM Dev. Biotransformation Endocrinology Hematology Metabolism Reproduction Pharmacology Nutrition Toxicology Ratings: 0 = No harm or not applicable, = 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 Mean SEM Dev. Instrumentation Ratings: 0 = No harm or not applicable, = 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. American College of Veterinary Pathologists 77 88

89 B 2009 Table 8: Point of Acquisition for Clinical Tools Frequency Analysis for Tools: Acquisition Scale Rating Count Percent Histology/Cytology Light Microscopy Standard HE Cytology (standard Wright-Giemsa) Histochemistry/ Cytochemistry (Special Stains) Immunohistochemistry /Immunocytochemistry In Situ Hybridization Photomicroscopy Clinical Pathology Clinical Chemistry Interpretation Hematology Interpretation Urinalysis Interpretation Clinical Chemistry Analyzers Hematology Analyzers Coagulation Analyzers Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 78 89

90 B 2009 Table 8 (Continued): Point of Acquisition for Clinical Tools Frequency Analysis for Tools: Acquisition Scale Rating Frequency Percent Blood Gas Analyzers Immunoassay Analyzers Special Microscopy Techniques Fluorescence Microscopy Transmission Electron Microscopy Immunoelectron Microscopy Scanning Electron Microscopy Confocal Microscopy Computer-Aided Slide Analysis Intravital Microscopy Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) Computer-Based Image Analysis Computer Modeling of Biological System/ 2 0. Organisms/Organs Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 79 90

91 B 2009 Table 8 (Continued): Point of Acquisition for Clinical Tools Frequency Analysis for Tools: Acquisition Scale Rating Frequency Percent Flow Cytometry Laser Capture Microdissection Spectrophotometry Cell Culture Telepathology In Vivo Imaging (e.g., bioluminescence) Biochemical and Molecular Techniques/ Tools PCR and Related Molecular Techniques Gene Microarray Protein Microarray Tissue Microarray Gene Regulation/ Mutagenesis Western Blotting and Related Proteomic Techniques Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 80 9

92 B 2009 Table 8 (Continued): Point of Acquisition for Clinical Tools Frequency Analysis for Tools: Acquisition Scale Rating Frequency Percent FISH/Cytogenetics Immunoassays (Radioimmunodiffusion Assays, ELISA, etc.) ph Assays Electrophoresis Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned Table 82: Criticality of Clinical Tools Tools N Mean SEM Dev. Histology/Cytology Light Microscopy Standard HE Cytology (standard Wright-Giemsa) Histochemistry/Cytochemistry(Special Stains) Immunohistochemistry/Immunocytochemistry In Situ Hybridization Photomicroscopy Clinical Pathology Clinical Chemistry Interpretation Hematology Interpretation Urinalysis Interpretation Clinical Chemistry Analyzers Hematology Analyzers Coagulation Analyzers Immunoassay Analyzers Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 8 92

93 B 2009 Table 82(Continued): Criticality of Clinical Tools N Tools Mean SEM Dev. Special Microscopy Techniques Fluorescence Microscopy Transmission Electron Microscopy Immunoelectron Microscopy Scanning Electron Microscopy Confocal Microscopy Computer-Aided Slide Analysis Intravital Microscopy Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) Computer-Based Image Analysis Computer Modeling of Biological System/ Organisms/Organs Flow Cytometry Laser Capture Microdissection Spectrophotometry Cell Culture Telepathology In Vivo Imaging (e.g., bioluminescence) Biochemical and Molecular Techniques/ Tools PCR and Related Molecular Techniques Gene Microarray Protein Microarray Tissue Microarray Gene Regulation/Mutagenesis Western Blotting and Related Proteomic Techniques FISH/Cytogenetics Immunoassays (Radioimmunodiffusion Assays, ELISA, etc.) ph Assays Electrophoresis Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 82 93

94 B 2009 Table 83: Frequency of Clinical Tools Tools N Mean SEM Dev. Histology/Cytology Light Microscopy Standard HE Cytology (standard Wright-Giemsa) Histochemistry/Cytochemistry(Special Stains) Immunohistochemistry/Immunocytochemistry In Situ Hybridization Photomicroscopy Clinical Pathology Clinical Chemistry Interpretation Hematology Interpretation Urinalysis Interpretation Clinical Chemistry Analyzers Hematology Analyzers Coagulation Analyzers Blood Gas Analyzers Immunoassay Analyzers Special Microscopy Techniques Fluorescence Microscopy Transmission Electron Microscopy Immunoelectron Microscopy Scanning Electron Microscopy Confocal Microscopy Computer-Aided Slide Analysis Intravital Microscopy Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) Computer-Based Image Analysis Computer Modeling of Biological System/ Organisms/Organs Flow Cytometry Laser Capture Microdissection Spectrophotometry Cell Culture Telepathology In Vivo Imaging (e.g., bioluminescence) Biochemical and Molecular Techniques/ Tools PCR and Related Molecular Techniques Gene Microarray Protein Microarray Tissue Microarray Gene Regulation/Mutagenesis Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 83 94

95 B 2009 Table 83: Frequency of Clinical Tools Tools N Mean SEM Dev. Western Blotting and Related Proteomic Techniques FISH/Cytogenetics Immunoassays (Radioimmunodiffusion Assays, ELISA, etc.) ph Assays Electrophoresis Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day 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 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. American College of Veterinary Pathologists 84 95

96 B 2009 Table 84: Reliability Estimates Anatomic Elements of Practice Element of Practice N # of Task s RELIABILITY Acquisitio n Criticality Frequency I. Research and Investigative Design II. Data Collection III. Data Analysis and Interpretation IV. Communication and Reporting V. Quality Assurance VI. Public Health and Risk Management VII. Education and Professional Development Table 85: Reliability Estimates Anatomic Foundational Sciences RELIABILITY Foundational Science # of Specific Sample Size(n) Sciences Criticality I. Anatomy and Physiology II. Biology III. Physical Sciences IV. Applied Mathematics and Statistics V. Medicine VI. Pathology VII. Microbiology and Infectious Disease American College of Veterinary Pathologists 85 96

97 B 2009 Table 86: Reliability Estimates Clinical Elements of Practice Element of Practice N # of Tasks RELIABILITY Acquisitio n Criticality Frequenc y I. Research and Investigative Design II. Data Collection, Data Analysis, and Interpretation III. Communication and Reporting IV. Quality Assurance V. Public Health and Risk Management VI. Education and Professional Development Table 87: Reliability Estimates Clinical Foundational Sciences RELIABILITY Foundational Science # of Specific Sample Size(n) Sciences Criticality I. Anatomy II. Applied Mathematics and Statistics III. Biology/Pathology IV. Chemistry V. Microbiology VI. Physiology/Pathophysiology VII. Physics 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 American College of Veterinary Pathologists 86 97

98 B 2009 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. American College of Veterinary Pathologists 87 98

99 B 2009 Appendix A: Analysis of Data for New Diplomates ( ) Demographics for New Diplomates ( ) Table : Degrees Earned * Degree Anatomic Clinical Frequency Percent Frequency Percent DVM/VMD (or equivalent) PhD MBA MPH Other Master s Other General * 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 Year Anatomic Clinical Frequency Percent Frequency Percent Total American College of Veterinary Pathologists 88 99

100 B 2009 Table 3: Other Certifications Earned* Certification Anatomic Clinical Frequency Percent Frequency Percent ABVP ABVT ACLAM ACPV ACTHERIO ACVA ACVB ACVCP ACVD ACVECC ACVIM ACVM ACVN ACVO ACVPM ACVR ACVS ACZM AVDC ABTOX ECVP ECVCP One Certification Not Listed Two Certifications Not Listed * NOTE: Respondents could select more than one certification, so it is not reasonable to add the frequency or percent information. American College of Veterinary Pathologists 89 00

101 B 2009 Table 4: Mean Frequency Estimates for Species Anatomic Clinical Species Standard Standard N Mean Deviation N Mean Deviation Birds Cats Cows Dogs Fish Horses Marine Mammals Non-Human Primates Pigs Pocket Pets Poultry Rabbits Reptiles and Amphibians Rodents Small Ruminants Wildlife Zoo Animals 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 Teaching Research Clinical Administration Diagnostic Government Industry Chemical Pharmaceutical Biotechnology Contract Medical Devices Research Private Practice Non-practicing Other Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 90 0

102 B 2009 Table 6: Administrative and/or Management Role Response Anatomic Clinical Frequency Percent Frequency Percent Yes No Total 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 Table 8: Respondents Involved in Training Veterinary Pathologists for Board Eligibility Response Anatomic Clinical Frequency Percent Frequency Percent Yes No Total Table 9: Percent of Time Spent in Training Veterinary Pathologists for Board Eligibility Anatomic Clinical N Mean Std Dev N Mean Std Dev Time Spent Table 0: Full and Part Time Work Status Response Anatomic Clinical Frequency Percent Frequency Percent Full time Part time Retired 0.6 Total Table : Percent of Time Spent Practicing Veterinary Pathology Anatomic Clinical N Mean Std Dev N Mean Std Dev Time Spent American College of Veterinary Pathologists 9 02

103 B 2009 Table 2: Primary State, Province, or International Region Location Anatomic Clinical Frequency Percent Frequency Percent USA Alaska Arkansas Alabama Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania South Carolina South Dakota Tennessee Texas Utah Virginia Washington American College of Veterinary Pathologists 92 03

104 B 2009 Table 2 (Continued): Primary State, Province, or International Region Location Anatomic Clinical Frequency Percent Frequency Percent USA Wisconsin West Virginia Wyoming Canada Alberta British Columbia Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan International Regions Africa Asia/Pacific Islands Australia Europe No Response Total Table 3: Gender Response Anatomic Clinical Frequency Percent Frequency Percent Male Female No Response Total American College of Veterinary Pathologists 93 04

105 B 2009 Anatomic Elements of Practice Validation of Veterinary Anatomic Pathologists Roles Table 4: Point of Acquisition for Anatomic Elements of Practice Element of Practice Rating Count Percent I. Research and Investigative Design II. Data Collection III Data Analysis and Interpretation IV. Communication and Reporting V. Quality Assurance VI. Public Health and Risk Management VII. Education and Professional Development Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned Table 5: Criticality of Anatomic Elements of Practice Element of Practice Mean Dev. N SEM I. Research and Investigative Design II. Data Collection III. Data Analysis and Interpretation IV. Communication and Reporting V. Quality Assurance VI. Public Health and Risk Management VII. Education and Professional Development Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 94 05

106 B 2009 Table 6: Frequency of Anatomic Elements of Practice Element of Practice Mean Dev. N SEM I. Research and Investigative Design II. Data Collection III. Data Analysis and Interpretation IV. Communication and Reporting V. Quality Assurance VI. Public Health and Risk Management VII. Education and Professional Development Ratings: 0 = Never, = 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 7: 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 Rating Count Percent Design experiments and diagnostic investigations Coordinate research and diagnostic investigations Develop investigational techniques Use animal models of disease Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned Table 8: Criticality of Tasks Within Anatomic Element of Practice I (Research and Investigative Design) Tasks Within Element of Practice I N Mean SEM Dev. Design experiments and diagnostic investigations Coordinate research and diagnostic investigations Develop investigational techniques Use animal models of disease Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 95 06

107 B 2009 Table 9: Frequency of Tasks Within Anatomic Element of Practice I (Research and Investigative Design) Tasks Within Element of Practice I N Mean SEM Dev. Design experiments and diagnostic investigations Coordinate research and diagnostic investigations Develop investigational techniques Use animal models of disease Ratings: 0 = Never, = 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) Tasks Within Element of Practice II: Point of Acquisition Scale Rating Count Percent Review antemortem data and history to collect relevant samples Guide sample collection by others Perform necropsies Collect gross morphometric data Collect specimens to preserve sample integrity Describe morphological observations Photograph gross and microscopic observations Select applicable assays Perform microscopic, morphometric, analyses, quantitative interpretations Perform critical reviews of literature and data Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 96 07

108 B 2009 Table 2: Criticality of Tasks Within Anatomic Element of Practice II (Data Collection) Tasks Within Element of Practice II N Mean SEM Dev. Review antemortem data and history to collect relevant samples Guide sample collection by others Perform necropsies Collect gross morphometric data Collect specimens to preserve sample integrity Describe morphological observations Photograph gross and microscopic observations Select applicable assays Perform microscopic, morphometric analyses, quantitative interpretations Perform critical reviews of literature and data Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 22: Frequency of Tasks Within Anatomic Element of Practice II (Data Collection) Tasks Within Element of Practice II N Mean SEM Dev. Review antemortem data and history to collect relevant samples Guide sample collection by others Perform necropsies Collect gross morphometric data Collect specimens to preserve sample integrity Describe morphological observations Photograph gross and microscopic observations Select applicable assays Perform microscopic, morphometric analyses, quantitative interpretations Perform critical reviews of literature and data Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 97 08

109 B 2009 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 Rating Count Percent Evaluate tissue morphology Use special microscopic techniques Interpret immunohistochem-istry, histochemistry, in situ immunochemistry and hybridization Interpret advanced tissuebased cellular and molecular biology data Integrate pathologic and epidemiological findings Integrate individual animal data Interpret normal variations and spontaneous findings Identify artifacts in tissue sections and other samples Organize complete data sets for study analysis Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 98 09

110 B 2009 Table 24: Criticality of Tasks Within Anatomic Element of Practice III (Data Analysis and Interpretation) Tasks Within Element of Practice III N Mean SEM Dev. Evaluate tissue morphology Use special microscopic techniques Interpret immunohistochemistry, histochemistry, in situ immunochemistry and hybridization Interpret advanced tissue-based cellular and molecular biology data Integrate pathologic and epidemiological findings Integrate individual animal data Interpret normal variations and spontaneous findings Identify artifacts in tissue sections and other samples Organize complete data sets for study analysis Ratings: 0 = No harm or not applicable, = 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) Tasks Within Element of Practice III N Mean SEM Dev. Evaluate tissue morphology Use special microscopic techniques Interpret immunohistochemistry, histochemistry, in situ immunochemistry and hybridization Interpret advanced tissue-based cellular and molecular biology data Integrate pathologic and epidemiological findings Integrate individual animal data Interpret normal variations and spontaneous findings Identify artifacts in tissue sections and other samples Organize complete data sets for study analysis Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 99 0

111 B 2009 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 Rating Count Percent Communicate pathology findings and their significance to clinicians, regulators, and scientists Communicate animal disease to the public Discuss scientific findings in public forums to educate stakeholders Publish scientific findings in peer reviewed literature Disseminate knowledge thru publications, abstracts, reports, and presentations Testify as an expert witness or as the 7.4 pathologist of record Ratings: 0 = not applicable, = 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) Tasks Within Element of Practice IV N Mean SEM Dev. Communicate pathology findings and their significance to clinicians, regulators, and scientists Communicate animal disease to the public Discuss scientific findings in public forums to educate stakeholders Publish scientific findings in peer reviewed literature Disseminate knowledge through publications, abstracts, reports, and presentations Testify as an expert witness or as the pathologist of record Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 00

112 B 2009 Table 28: Frequency of Tasks Within Anatomic Element of Practice IV (Communication and Reporting) Tasks Within Element of Practice IV N Mean SEM Dev. Communicate pathology findings and their significance to clinicians, regulators, and scientists Communicate animal disease to the public Discuss scientific findings in public forums to educate stakeholders Publish scientific findings in peer reviewed literature Disseminate knowledge through publications, abstracts, reports, and presentations Testify as an expert witness or as the pathologist of record Ratings: 0 = Never, = 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) Tasks Within Element of Practice V: Point of Acquisition Scale Rating Count Percent Conduct reviews of designs, proposals, results, and manuscripts Supervise technical staff Conduct pathology peer review Resolve discrepancies using pathology working groups and external experts Provide results in accordance with SOPs or scientific principles Author standard operating procedures Conduct laboratory inspections Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 0 2

113 B 2009 Table 30: Criticality of Tasks Within Anatomic Element of Practice V (Quality Assurance) Tasks Within Element of Practice V N Mean SEM Dev. Conduct reviews of designs, proposals, results, and manuscripts Supervise technical staff Conduct pathology peer review Resolve discrepancies using pathology working groups and external experts Provide results in accordance with SOPs or scientific principles Author standard operating procedures Conduct laboratory inspections Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 3: Frequency of Tasks Within Anatomic Element of Practice V (Quality Assurance) Tasks Within Element of Practice V N Mean SEM Dev. Conduct reviews of designs, proposals, results, and manuscripts Supervise technical staff Conduct pathology peer review Resolve discrepancies using pathology working groups and external experts Provide results in accordance with SOPs or scientific principles Author standard operating procedures Conduct laboratory inspections Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 02 3

114 B 2009 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 Rating Count Percent Monitor disease trends using databases and networking Recognize novel manifestations of disease Train others to detect disease threats Detect diseases that threaten public or animal health Report disease occurrence Develop rational disease mitigation strategy Characterize responses in animals to provide risk assessment Integrate animal disease and population management information to improve risk assessment Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 03 4

115 B 2009 Table 33: Criticality of Tasks Within Anatomic Element of Practice VI (Public Health and Risk Management) Tasks Within Element of Practice VI N Mean SEM Dev. Monitor disease trends using databases and networking Recognize novel manifestations of disease Train others to detect disease threats Detect diseases that threaten public or animal health Report disease occurrence Develop rational disease mitigation strategy Characterize responses in animals to provide risk assessment Integrate animal disease and population management information with animal population management Ratings: 0 = No harm or not applicable, = 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) Tasks Within Element of Practice VI N Mean SEM Dev. Monitor disease trends using databases and networking Recognize novel manifestations of disease Train others to detect disease threats Detect diseases that threaten public or animal health Report disease occurrence Develop rational disease mitigation strategy Characterize responses in animals to provide risk assessment Integrate animal disease and population management information with animal population management Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 04 5

116 B 2009 Table 35: Point of Acquisition for Tasks Within Anatomic Element of Practice VII (Education and Professional Development) Tasks Within Element of Practice VI: Point of Acquisition Scale Rating Count Percent Conduct reviews of designs, proposals, results, and manuscripts Educate regulators, other scientists, and officials Serve as an expert consultant Instruct professionals to advance the discipline of pathology Promote personal and professional development Mentor others regarding organizations and career opportunities Train others in veterinary pathology to impart technical proficiency Train personnel in safe specimen handling Serve on professional and scientific committees Model the responsible conduct of research Mentor graduate students and postdoctoral trainees in research Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 05 6

117 B 2009 Table 36: Criticality of Tasks Within Anatomic Element of Practice VII (Education and Professional Development) Tasks Within Element of Practice VII N Mean SEM Dev. Conduct reviews of designs, proposals, results, and manuscripts Educate regulators, other scientists, and officials Serve as an expert consultant Instruct professionals to advance the discipline of pathology Promote personal and professional development Mentor others regarding organizations and career opportunities Train others in veterinary pathology to impart technical proficiency Train personnel in safe specimen handling Serve on professional and scientific committees Model the responsible conduct of research Mentor graduate students and postdoctoral trainees in research Ratings: 0 = No harm or not applicable, = 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) Tasks Within Element of Practice VII N Mean SEM Dev. Conduct reviews of designs, proposals, results, and manuscripts Educate regulators, other scientists, and officials Serve as an expert consultant Instruct professionals to advance the discipline of pathology Promote personal and professional development Mentor others regarding organizations and career opportunities Train others in veterinary pathology to impart technical proficiency Train personnel in safe specimen handling Serve on professional and scientific committees Model the responsible conduct of research Mentor graduate students and postdoctoral trainees in research Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 06 7

118 B 2009 Anatomic Foundational Sciences Table 38: Point of Acquisition for Anatomic Foundational Sciences Frequency Analysis for Foundational Sciences: Acquisition Scale Rating Frequency Percent Anatomy and Physiology Biology Physical Sciences Applied Mathematics and Statistics Medicine Pathology Microbiology and Infectious Disease Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned Table 39: Criticality of Anatomic Foundational Sciences Foundational Science Mean Dev. N SEM I. Anatomy and Physiology II. Biology III. Physical Sciences IV. Applied Mathematics and Statistics V. Medicine VI. Pathology VII. Microbiology and Infectious Disease Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 07 8

119 B 2009 Table 40: Frequency of Anatomic Foundational Sciences Foundational Sciences Mean Dev. N SEM I. Anatomy and Physiology II. Biology III. Physical Sciences IV. Applied Mathematics and Statistics V. Medicine VI. Pathology VII. Microbiology and Infectious Disease Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Specific Sciences Within Anatomic Foundational Sciences Table 4: Criticality of Specific Sciences in Anatomic Foundational Science I: Anatomy and Physiology Specific Sciences N Mean SEM Dev. Macroscopic Anatomy Microscopic Anatomy Histology Cytology Ultrastructure Physiology Immunology Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 4: Criticality of Specific Sciences in Anatomic Foundational Science II: Biology Specific Sciences N Mean SEM Dev. Zoology Cell and Molecular Biology Developmental Biology Genetics Ecology Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 08 9

120 B 2009 Table 42: Criticality of Specific Sciences in Anatomic Foundational Science III: Physical Sciences Specific Sciences N Mean SEM Dev. Biochemistry Organic Chemistry Inorganic Chemistry Physics Ratings: 0 = No harm or not applicable, = 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 Specific Sciences N Mean SEM Dev. Biostatistics Bioinformatics Epidemiology Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 44: Criticality of Specific Sciences in Anatomic Foundational Science V: Medicine Specific Sciences N Mean SEM Dev. Pharmacology Toxicology Diagnostic Imaging Comparative Medicine Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 45: Criticality of Specific Sciences in Anatomic Foundational Science VI: Pathology Specific Sciences N Mean SEM Dev. General Pathology Systemic Pathology Clinical Pathology Cell and Molecular Pathology Ratings: 0 = No harm or not applicable, = 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 Specific Sciences N Mean SEM Dev. Virology Bacteriology Mycology Parasitology Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 09 20

121 B 2009 Evaluation of Anatomic Tools Table 47: Point of Acquisition for Anatomic Tools Frequency Analysis for Tools: Acquisition Scale Rating Frequency Percent Histology/Cytology Light Microscopy (Standard HE) Cytology (standard Wright-Giemsa) Histochemistry/ Cytochemistry (Special Stains) Immunohistochemistry /Immunocytochemistry In Situ Hybridization Photomicroscopy Clinical Pathology Clinical Chemistry Interpretation Hematology Interpretation Urinalysis Interpretation Clinical Chemistry Analyzers Hematology Analyzers Coagulation Analyzers Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 0 2

122 B 2009 Table 47 (Continued): Point of Acquisition for Anatomic Tools Frequency Analysis for Tools: Acquisition Scale Rating Frequency Percent Blood Gas Analyzers Immunoassay Analyzers Special Microscopy Techniques Fluorescence Microscopy Transmission Electron Microscopy Immunoelectron Microscopy Scanning Electron Microscopy Confocal Microscopy Computer-Aided Slide Analysis Intravital Microscopy Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) Computer-Based Image Analysis Computer Modeling of Biological System/ Organisms/Organs Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 22

123 B 2009 Table 47 (Continued): Point of Acquisition for Anatomic Tools Frequency Analysis for Tools: Acquisition Scale Rating Frequency Percent Flow Cytometry Laser Capture Microdissection Spectrophotometry Cell Culture Telepathology In Vivo Imaging (e.g., bioluminescence) Biochemical and Molecular Techniques/ Tools PCR and Related Molecular Techniques Gene Microarray Protein Microarray Tissue Microarray Gene Regulation/ Mutagenesis Western Blotting and Related Proteomic Techniques Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 2 23

124 B 2009 Table 47 (Continued): Point of Acquisition for Anatomic Tools Frequency Analysis for Tools: Acquisition Scale Rating Frequency Percent FISH/Cytogenetics Immunoassays (Radioimmunodiffusion Assays, ELISA, etc.) ph Assays Electrophoresis Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned Table 48: Criticality of Anatomic Tools Tools N Mean SEM Dev. Histology/Cytology Light Microscopy (Standard HE) Cytology (standard Wright-Giemsa) Histochemistry/Cytochemistry(Special Stains) Immunohistochemistry/Immunocytochemistry In Situ Hybridization Photomicroscopy Clinical Pathology Clinical Chemistry Interpretation Hematology Interpretation Urinalysis Interpretation Clinical Chemistry Analyzers Hematology Analyzers Coagulation Analyzers Blood Gas Analyzers Immunoassay Analyzers Special Microscopy Techniques Fluorescence Microscopy Transmission Electron Microscopy Immunoelectron Microscopy Scanning Electron Microscopy Confocal Microscopy Computer-Aided Slide Analysis Intravital Microscopy Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 3 24

125 B 2009 Table 48 (Continued): Criticality of Anatomic Tools Tools N Mean SEM Dev. Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) Computer-Based Image Analysis Computer Modeling of Biological System/ Organisms/Organs Flow Cytometry Laser Capture Microdissection Spectrophotometry Cell Culture Telepathology In Vivo Imaging (e.g., bioluminescence) Biochemical and Molecular Techniques/ Tools PCR and Related Molecular Techniques Gene Microarray Protein Microarray Tissue Microarray Gene Regulation/Mutagenesis Western Blotting and Related Proteomic Techniques FISH/Cytogenetics Immunoassays (Radioimmunodiffusion Assays, ELISA, etc.) ph Assays Electrophoresis Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 49: Frequency of Anatomic Tools Tools N Mean SEM Dev. Histology/Cytology Light Microscopy Standard HE Cytology (standard Wright-Giemsa) Histochemistry/Cytochemistry(Special Stains) Immunohistochemistry/Immunocytochemistry In Situ Hybridization Photomicroscopy American College of Veterinary Pathologists 4 25

126 B 2009 Table 49 (Continued): Frequency of Anatomic Tools Tools N Mean SEM Dev. Clinical Pathology Clinical Chemistry Interpretation Hematology Interpretation Urinalysis Interpretation Clinical Chemistry Analyzers Hematology Analyzers Coagulation Analyzers Blood Gas Analyzers Immunoassay Analyzers Special Microscopy Techniques Fluorescence Microscopy Transmission Electron Microscopy Immunoelectron Microscopy Scanning Electron Microscopy Confocal Microscopy Computer-Aided Slide Analysis Intravital Microscopy Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) Computer-Based Image Analysis Computer Modeling of Biological System/ Organisms/Organs Flow Cytometry Laser Capture Microdissection Spectrophotometry Cell Culture Telepathology In Vivo Imaging (e.g., bioluminescence) Biochemical and Molecular Techniques/ Tools PCR and Related Molecular Techniques Gene Microarray Protein Microarray Tissue Microarray Gene Regulation/Mutagenesis Western Blotting and Related Proteomic Techniques FISH/Cytogenetics Immunoassays (Radioimmunodiffusion Assays, ELISA, etc.) ph Assays Electrophoresis Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 5 26

127 B 2009 Clinical Elements of Practice Elements of Practice for Veterinary Clinical Pathologists Table 50: Point of Acquisition for Clinical Elements of Practice Element of Practice Rating Count Percent I. Research and Investigative Design II. Data Collection, Analysis, and Interpretation III. Communication and Reporting IV. Quality Assurance V. Public Health and Risk Management VI. Education and Professional Development Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned Table 5: Criticality of Clinical Elements of Practice Element of Practice Mean Dev. N SEM I. Research and Investigative Design II. Data Collection, Analysis, and Interpretation III. Communication and Reports IV. Quality Assurance V. Public Health and Risk Management VI. Education and Professional Development Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 6 27

128 B 2009 Table 52: Frequency of Clinical Elements of Practice Element of Practice Mean Dev. N SEM I. Research and Investigative Design II. Data Collection, Analysis, and Interpretation III. Communication and Reports IV. Quality Assurance V. Public Health and Risk Management VI. Education and Professional Development Ratings: 0 = Never, = 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) Tasks Within Element of Practice I: Point of Acquisition Scale Rating Count Percent Gather technical and scientific information to optimize study results Contribute to the study design Instruct clinicians, technical staff, and other professionals in assay selection and sample collection Recommend ancillary or follow-up testing Independently construct a hypothesis-driven investigation Develop investigational techniques and assays in clinical pathology Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 7 28

129 B 2009 Table 54: Criticality of Tasks Within Clinical Element of Practice I (Research and Investigative Design) Tasks Within Element of Practice I N Mean SEM Dev. Gather technical and scientific information to optimize study results Contribute to the study design Instruct clinicians, technical staff, and other professionals in assay selection and sample collection Recommend ancillary or follow-up testing Independently construct a hypothesis-driven investigation Develop investigational techniques and assays in clinical pathology Ratings: 0 = No harm or not applicable, = 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) Tasks Within Element of Practice I N Mean SEM Dev. Gather technical and scientific information to optimize study results Contribute to the study design Instruct clinicians, technical staff, and other professionals in assay selection and sample collection Recommend ancillary or follow-up testing Independently construct a hypothesis-driven investigation Develop investigational techniques and assays in clinical pathology Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 8 29

130 B 2009 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 Rating Count Percent Understand the principles of current pathology instrumentation Collect samples using appropriate methods Direct the collection of samples Describe light and electron microscopic observations Interpret light and electron microscopic observations Describe hematological and hemostasis data Interpret hematological and hemostasis data Describe clinical chemistry data Interpret clinical chemistry data Describe data generated from the analysis of urine and other body fluids Interpret data generated from the analysis of urine and other body fluids Describe data generated from immunoassays Interpret data generated from immunoassays Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 9 30

131 B 2009 Table 56 (Continued): 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 Rating Count Percent Utilize molecular methods and novel testing techniques Utilize specialized microscopic techniques Archive samples and/or related data Apply proper statistical tests Provide a contextual interpretation Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 20 3

132 B 2009 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 Dev. Understand the principles of current pathology instrumentation Collect samples using appropriate methods Direct the collection of samples Describe light and electron microscopic observations Interpret light and electron microscopic observations Describe hematological and hemostasis data Interpret hematological and hemostasis data Describe clinical chemistry data Interpret clinical chemistry data Describe data generated from the analysis of urine and other body fluids Interpret data generated from the analysis of urine and other body fluids Describe data generated from immunoassays Interpret data generated from immunoassays Utilize molecular methods and novel testing techniques Utilize specialized microscopic techniques Archive samples and/or related data Apply proper statistical tests Provide a contextual interpretation Ratings: 0 = No harm or not applicable, = 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) Tasks Within Element of Practice II N Mean SEM Dev. Understand the principles of current pathology instrumentation Collect samples using appropriate methods Direct the collection of samples Describe light and electron microscopic observations Interpret light and electron microscopic observations Describe hematological and hemostasis data Interpret hematological and hemostasis data Describe clinical chemistry data Interpret clinical chemistry data Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 2 32

133 B 2009 Table 58 (Continued): Frequency of Tasks Within Clinical Element of Practice II (Data Collection, Analysis, and Interpretation) Tasks Within Element of Practice II N Mean SEM Dev. Describe data generated from the analysis of urine and other body fluids Interpret data generated from the analysis of urine and other body fluids Describe data generated from immunoassays Interpret data generated from immunoassays Utilize molecular methods and novel testing techniques Utilize specialized microscopic techniques Archive samples and/or related data Apply proper statistical tests Provide a contextual interpretation Ratings: 0 = Never, = 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) Tasks Within Element of Practice III: Point of Acquisition Scale Rating Count Percent Write clinical pathology reports Author manuscripts Deliver scientific or technical presentations Communicate the significance of clinical pathology results Respond to formal inquiries from regulatory agencies or other groups Communicate clinical pathology knowledge Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 22 33

134 B 2009 Table 60: Criticality of Tasks Within Clinical Element of Practice III (Communication and Reporting) Tasks Within Element of Practice III N Mean SEM Dev. Write clinical pathology reports Author manuscripts Deliver scientific or technical presentations Communicate the significance of clinical pathology results Respond to formal inquiries from regulatory agencies or other groups Communicate clinical pathology knowledge Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 6: Frequency of Tasks Within Clinical Element of Practice III (Communication and Reporting) Tasks Within Element of Practice III N Mean SEM Dev. Write clinical pathology reports Author manuscripts Deliver scientific or technical presentations Communicate the significance of clinical pathology results Respond to formal inquiries from regulatory agencies or other groups Communicate clinical pathology knowledge Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 23 34

135 B 2009 Table 62: Point of Acquisition for Tasks Within Clinical Element of Practice IV (Quality Assurance) Tasks Within Element of Practice IV: Point of Acquisition Scale Rating Count Percent Define standard operating procedures Evaluate specimens, reagents, instruments, and personnel training to ensure validity of data Evaluate data for evidence of preanalytical and analytical error Resolve quality assurance problems Develop and improve assays Conduct reviews of reports and manuscripts Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned Table 63: Criticality of Tasks Within Clinical Element of Practice IV (Quality Assurance) Tasks Within Element of Practice IV N Mean SEM Dev. Define standard operating procedures Evaluate specimens, reagents, instruments, and personnel training to ensure validity of data Evaluate data for evidence of preanalytical and analytical error Resolve quality assurance problems Develop and improve assays Conduct reviews of reports and manuscripts Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 24 35

136 B 2009 Table 64: Frequency of Tasks Within Clinical Element of Practice IV (Quality Assurance) Tasks Within Element of Practice IV N Mean SEM Dev. Define standard operating procedures Evaluate specimens, reagents, instruments, and personnel training to ensure validity of data Evaluate data for evidence of preanalytical and analytical error Resolve quality assurance problems Develop and improve assays Conduct reviews of reports and manuscripts Ratings: 0 = Never, = 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) Tasks Within Element of Practice V: Point of Acquisition Scale Rating Count Percent Design safe sample handling protocols for infectious and toxic agents Design protocols to manage chemicals and 8 2. laboratory waste Recognize the public health significance of infectious agents Design clinical pathology testing strategies for disease surveillance Integrate clinical and comparative pathology data to understand implications Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 25 36

137 B 2009 Table 66: Criticality of Tasks Within Clinical Element of Practice V (Public Health and Risk Management) Tasks Within Element of Practice V N Mean SEM Dev. Design safe sample handling protocols for infectious and toxic agents Design protocols to manage chemicals and laboratory waste Recognize the public health significance of infectious agents Design clinical pathology testing strategies for disease surveillance Integrate clinical pathology and comparative pathology data to understand implications Ratings: 0 = No harm or not applicable, = 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) Tasks Within Element of Practice V N Mean SEM Dev. Design safe sample handling protocols for infectiousad toxic agents Design protocols to manage chemicals and laboratory waste Recognize the public health significance of infectious agents Design clinical pathology testing strategies for disease surveillance Integrate clinical pathology and comparative pathology data to understand implications Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 26 37

138 B 2009 Table 68: Point of Acquisition for Tasks Within Clinical Element of Practice VI (Education and Professional Development) Tasks Within Element of Practice VI: Point of Acquisition Scale Rating Count Percent Instruct veterinary students Instruct veterinary pathology residents Provide continuing education and training Provide mentorship and guidance to trainees and colleagues Participate in professional development activities Provide education to the public in aspects of veterinary clinical pathology Serve on professional and 4. scientific committees Ratings: 0 = not applicable, = 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) Tasks Within Element of Practice VI N Mean SEM Dev. Instruct veterinary students Instruct veterinary pathology residents Provide continuing education and training Provide mentorship and guidance to trainees and colleagues Participate in professional development activities Provide education to the public in aspects of veterinary clinical pathology Serve on professional and scientific committees Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 27 38

139 B 2009 Table 70: Frequency of Tasks Within Clinical Element of Practice VI (Education and Professional Development) Tasks Within Element of Practice VI N Mean SEM Dev. Instruct veterinary students Instruct veterinary pathology residents Provide continuing education and training Provide mentorship and guidance to trainees and colleagues Participate in professional development activities Provide education to the public in aspects of veterinary clinical pathology Serve on professional and scientific committees Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day Evaluation of Clinical Foundational Sciences Table 7: Point of Acquisition for Clinical Foundational Sciences Frequency Analysis for Foundational Sciences: Acquisition Scale Rating Frequency Percent Anatomy Applied Mathematics and Statistics Biology/Pathology Chemistry Microbiology Physiology/ Pathophysiology Physics Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 28 39

140 B 2009 Table 72: Criticality of Clinical Foundational Sciences Foundational Science Mean Dev. N SEM I. Anatomy II. Applied Mathematics and Statistics III. Biology/Pathology IV. Chemistry V. Microbiology VI. Physiology/Pathophysiology VII. Physics Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 73: Frequency of Clinical Foundational Sciences Performance Domain Mean Dev. N SEM I. Anatomy II. Applied Mathematics and Statistics III. Biology/Pathology IV. Chemistry V. Microbiology VI. Physiology/Pathophysiology VII. Physics Ratings: 0 = Never, = 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 Specific Sciences N Mean SEM Dev. Macroscopic Anatomy Microscopic Anatomy Histology Cytology Ultrastructural Anatomy Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 29 40

141 B 2009 Table 75: Criticality of Specific Sciences in Clinical Foundational Science II: Applied Mathematics and Statistics Specific Sciences N Mean SEM Dev. Data Management Systems Biostatistics Bioinformatics Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 76: Criticality of Specific Sciences in Clinical Foundational Science III: Biology/Pathobiology Specific Sciences N Mean SEM Dev. Cell Biology Developmental Biology and Aging Genetics Immunology Molecular Biology Cancer Biology Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 77: Criticality of Specific Sciences in Clinical Foundational Science IV: Chemistry Specific Sciences N Mean SEM Dev. Biochemistry Clinical Chemistry Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm Table 78: Criticality of Specific Sciences in Clinical Foundational Science V: Microbiology Specific Sciences N Mean SEM Dev. Mycology Virology Parasitology Bacteriology Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 30 4

142 B 2009 Table 79: Criticality of Specific Sciences in Clinical Foundational Science VI: Physiology/ Pathophysiology Specific Sciences N Mean SEM Dev. Biotransformation Endocrinology Hematology Metabolism Reproduction Pharmacology Nutrition Toxicology Ratings: 0 = No harm or not applicable, = 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 Mean SEM Dev. Instrumentation Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 3 42

143 B 2009 Evaluation of Tools Table 8: Point of Acquisition for Clinical Tools Frequency Analysis for Tools: Acquisition Scale Rating Count Percent Histology/Cytology Light Microscopy Standard HE Cytology (standard Wright-Giemsa) Histochemistry/ Cytochemistry (Special Stains) Immunohistochemistry /Immunocytochemistry In Situ Hybridization Photomicroscopy Clinical Pathology Clinical Chemistry Interpretation Hematology Interpretation Urinalysis Interpretation Clinical Chemistry Analyzers Hematology Analyzers Coagulation Analyzers Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 32 43

144 B 2009 Table 8 (Continued): Point of Acquisition for Clinical Tools Frequency Analysis for Tools: Acquisition Scale Rating Frequency Percent Blood Gas Analyzers Immunoassay Analyzers Special Microscopy Techniques Fluorescence Microscopy Transmission Electron Microscopy Immunoelectron Microscopy Scanning Electron Microscopy Confocal Microscopy Computer-Aided Slide Analysis Intravital Microscopy Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) 2 4. Computer-Based Image Analysis Computer Modeling of Biological System/ Organisms/Organs Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 33 44

145 B 2009 Table 8 (Continued): Point of Acquisition for Clinical Tools Frequency Analysis for Tools: Acquisition Scale Rating Frequency Percent Flow Cytometry Laser Capture Microdissection Spectrophotometry Cell Culture Telepathology In Vivo Imaging (e.g., bioluminescence) Biochemical and Molecular Techniques/ Tools PCR and Related Molecular Techniques Gene Microarray Protein Microarray Tissue Microarray Gene Regulation/ Mutagenesis Western Blotting and Related Proteomic 30.6 Techniques Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned American College of Veterinary Pathologists 34 45

146 B 2009 Table 8 (Continued): Point of Acquisition for Clinical Tools Frequency Analysis for Tools: Acquisition Scale Rating Frequency Percent FISH/Cytogenetics Immunoassays (Radioimmunodiffusion Assays, ELISA, etc.) ph Assays Electrophoresis Ratings: 0 = not applicable, = expected of new diplomates, 2 = acquired after board certification is earned Table 82: Criticality of Clinical Tools Tools N Mean SEM Dev. Histology/Cytology Light Microscopy Standard HE Cytology (standard Wright-Giemsa) Histochemistry/Cytochemistry(Special Stains) Immunohistochemistry/Immunocytochemistry In Situ Hybridization Photomicroscopy Clinical Pathology Clinical Chemistry Interpretation Hematology Interpretation Urinalysis Interpretation Clinical Chemistry Analyzers Hematology Analyzers Coagulation Analyzers Blood Gas Analyzers Immunoassay Analyzers Special Microscopy Techniques Fluorescence Microscopy Transmission Electron Microscopy Immunoelectron Microscopy Scanning Electron Microscopy Confocal Microscopy Computer-Aided Slide Analysis Intravital Microscopy Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 35 46

147 B 2009 Table 83 (Continued): Criticality of Clinical Tools Tools N Mean SEM Dev. Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) Computer-Based Image Analysis Computer Modeling of Biological System/ Organisms/Organs Flow Cytometry Laser Capture Microdissection Spectrophotometry Cell Culture Telepathology In Vivo Imaging (e.g., bioluminescence) Biochemical and Molecular Techniques/ Tools PCR and Related Molecular Techniques Gene Microarray Protein Microarray Tissue Microarray Gene Regulation/Mutagenesis Western Blotting and Related Proteomic Techniques FISH/Cytogenetics Immunoassays (Radioimmunodiffusion Assays, ELISA, etc.) ph Assays Electrophoresis Ratings: 0 = No harm or not applicable, = Minimal harm, 2 = Moderate harm, 3 = Substantial harm, 4 = Extreme harm American College of Veterinary Pathologists 36 47

148 B 2009 Table 83: Frequency of Clinical Tools Tools N Mean SEM Dev. Histology/Cytology Light Microscopy Standard HE Cytology (standard Wright-Giemsa) Histochemistry/Cytochemistry(Special Stains) Immunohistochemistry/Immunocytochemistry In Situ Hybridization Photomicroscopy Clinical Pathology Clinical Chemistry Interpretation Hematology Interpretation Urinalysis Interpretation Clinical Chemistry Analyzers Hematology Analyzers Coagulation Analyzers Blood Gas Analyzers Immunoassay Analyzers Special Microscopy Techniques Fluorescence Microscopy Transmission Electron Microscopy Immunoelectron Microscopy Scanning Electron Microscopy Confocal Microscopy Computer-Aided Slide Analysis Intravital Microscopy Other Investigational Techniques/Tools Non-Invasive Imaging (CT, PET, Ultrasound, Magnetic Resonance) Computer-Based Image Analysis Computer Modeling of Biological System/ Organisms/Organs Flow Cytometry Laser Capture Microdissection Spectrophotometry Cell Culture Telepathology In Vivo Imaging (e.g., bioluminescence) Biochemical and Molecular Techniques/ Tools PCR and Related Molecular Techniques Gene Microarray Protein Microarray Tissue Microarray Gene Regulation/Mutagenesis Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 37 48

149 B 2009 Table 83: Frequency of Clinical Tools Tools N Mean SEM Dev. Western Blotting and Related Proteomic Techniques FISH/Cytogenetics Immunoassays (Radioimmunodiffusion Assays, ELISA, etc.) ph Assays Electrophoresis Ratings: 0 = Never, = Once per year, 2 = Once per month, 3 = Once per week, 4 = Once or more per day American College of Veterinary Pathologists 38 49

150 B 2009 Reliability Analysis of Scales for Elements of Practice Table 84: Reliability Estimates Anatomic Elements of Practice Element of Practice N # of Task s RELIABILITY Acquisitio n Criticality Frequency I. Research and Investigative Design II. Data Collection III. Data Analysis and Interpretation IV. Communication and Reporting V. Quality Assurance VI. Public Health and Risk Management VII. Education and Professional Development Table 85: Reliability Estimates Anatomic Foundational Sciences RELIABILITY Foundational Science # of Specific Sample Size(n) Sciences Criticality I. Anatomy and Physiology II. Biology III. Physical Sciences IV. Applied Mathematics and Statistics V. Medicine VI. Pathology VII. Microbiology and Infectious Disease American College of Veterinary Pathologists 39 50

151 B 2009 Table 86: Reliability Estimates Clinical Elements of Practice Element of Practice N # of Tasks RELIABILITY Acquisitio n Criticality Frequenc y I. Research and Investigative Design II. Data Collection, Data Analysis, and Interpretation III. Communication and Reporting IV. Quality Assurance V. Public Health and Risk Management VI. Education and Professional Development 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 RELIABILITY Foundational Science # of Specific Sample Size(n) Sciences Criticality I. Anatomy II. Applied Mathematics and Statistics III. Biology/Pathology IV. Chemistry V. Microbiology VI. Physiology/ Pathophysiology VII. Physics American College of Veterinary Pathologists 40 5

152 B2 Scope of the ACVP Certifying Examination - Clinical Pathology 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. 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:

153 I Invention Phase Panel Participants Name Invention Committee Committee Represented Specialty Practice Experience Ackermann, Mark Council AP A 2 Agnew, Dalen Examination Committee AP A 3 Berent, Linda CEB CP/AP A 4 Bienzle, Dorothee CEB/CERC CP A 5 Coleman, Gary ABVS Liaison AP G/I 6 Cregar, Laura CEB CP I 7 Harris, Keith CEB AP G/I/A 8 Howerth, Buffy CEB/CERC AP A 9 Lenz, Stephen CERC Member AP A 0 Lewis, Anne CEB AP A Miller, Andrew Examination Committee AP A 2 Pinson, David CEB AP A 3 Richey, Lauren Credentialing Committee AP A 4 Robinson, Nick Training Program Committee AP A 5 Rudmann, Dan CEB AP I 6 Simpson, Mark Council AP G 7 Stromberg, Paul CEB AP A 8 Webb, Julie Examination Committee/CERC CP A 9 Weiser, Glade CEB/CERC CP A/I 20 Wellman, Maxey CEB CP A A: Academia G: Government I: Industry 53

154 I2 Invention Phase Draft JTA Tasks Job Task Analysis, Clinical Pathology: Refinement Phase Background The American Board of Veterinary Specialties (ABVS) requires that each constituent specialty college or board conduct a Job/Task Analysis (JTA) at least every 0 years. The ABVS defines a Job/task analysis as follows: Job/task analysis A systematic procedure for defining the tasks required by a job and the knowledge, skills, abilities, and other personal characteristics required of individuals performing that job. The results of a job/task analysis form the basis for determining the examination contents necessary to test mastery of that field. The ACVP conducted a (RDS) in , facilitated by Dr. Jim Henderson of Castle Worldwide. Results of this study were published in A test plan was developed based on that study and the Examination Committee (EC) mapped test items to the test plan beginning in 200. Successive ECs have revised the test plan to more accurately reflect exam content, while still adhering to the results of the RDS. The Certifying Examination Board (CEB) was formed in 20 and reviews the test plan annually. In 202, the test plan was evaluated in depth and modified by a subcommittee of the CEB with the support of Dr. Jim Henderson. The College s decision in 205 to redesign the Phase II CE with implementation in 207 prompted the need to conduct a new RDS. The CEB elected to use terminology Job/Task Analysis (JTA) rather than RDS going forward as the former is consistent with the terminology used by the ABVS. In 205, the CEB, starting with the data and conclusions derived from the 2009 RDS, developed and approved the Scope of the ACVP Certifying Examination documents for the Phase II examination for anatomic and clinical pathology. These documents describe the key tasks performed by entry-level veterinary pathologists engaged in both specialties. In March 206, the CEB drafted a document outlining the JTA process, with an objective of completing this task and generating a Blueprint for the 207 Phase II CE and the 208 Phase I examination by the 206 Annual Meeting. Although a Job/Task Analysis is a best practice for high stakes certifying examinations, there is no single method recommended for conducting this analysis (National Commission for Certifying Agencies Standards for the Accreditation of Certifying Programs, Standard 0). The CEB, with approval of ACVP Council, elected to conduct a JTA building on the data collected from the RDS, the experience gained by the EC and the CEB over the last 7 years working with the test plan based on that study, the current CE test plan matrix and the Scope of ACVP Certifying Examination documents. The CEB also recognized that the composition of the current examination, developed annually for over five decades by generations of Examination Committee members representative of the College at large, represents valuable historical data relative to CE content. The phases of JTA are as follows: 54

155 I2 Invention Phase Draft JTA Tasks. Invention. This phase is conducted by the extended CEB which is composed of core members appointed by Council and 9 ad hoc members representing relevant ACVP committees. The objective of this phase is to produce a draft JTA document for subsequent levels of broader review. This document will include assigned percentages for: ) each of the testable Tasks identified in the Scope of the ACVP Certifying Examination as needed for Ability at Entry anatomic pathologists and 2) Blueprint categories of species, organ system and process to be applied across all Tasks. 2. Refinement. In this phase, two panels, one for anatomic pathology (20 members) and one for clinical pathology (5 members), will be asked to review the draft documents and provide feedback to the CEB for refinement consideration. The CEB will select the two panels, ensuring they are representative of the demographics of the College. 3. Validation. In this phase, the ACVP membership will be asked to participate in a survey asking for a -3 level agreement on each item of the JTA. Members will also be asked to provide reasons for disagreements. Following its review of the membership survey results, the CEB will further refine the JTA. 4. Approval. The final document will be submitted to Council for approval. Following approval, the EC will use the Blueprint section of the JTA for CE development and mapping. TASK AND BLUEPRINT LISTS AND DRAFT CONTENT PERCENTAGES FOR CLINICAL PATHOLOGY TASK : Identify, describe and interpret microscopic abnormalities in blood, bone marrow, body fluids, and tissues (cytology and histology) from domestic and non-domestic animals Tested via glass slides and image-based MCQs ~30% of Phase II Skills and knowledge: Write a coherent, organized descriptive report Summarize relative to the descriptive findings Interpretive conclusion(s) and/or diagnosis(es) Give appropriate disease, condition, and/or differential diagnoses Give potential causes(s) Give associated changes in other organ Give appropriate ancillary tests and anticipated results (e.g. special stains, immunohistochemistry, electron microscopy, PCR-based clonality, flow cytometry, cytology, other specialized laboratory tests in realms of biochemistry, serology, microbiology, immunodiagnostics) TASK 2: Recognize and interpret static visual test results pertinent to veterinary clinical pathology Tested via image-based MCQs ~5% of the Phase II Skills and knowledge for interpretation of: Hematology cytograms Flow cytometry plots 55

156 I2 Invention Phase Draft JTA Tasks Coagulation tracings Macroscopic hematology test results (eg. Coombs tests) Special and immunochemical stains Electron micrographs Quality assurance and quality control data. PCR clonality results TASK 3: Interpret and communicate clinicopathologic data from domestic and non-domestic animals Tested via case essays and MCQs ~25% of the entire Phase II exam. Skills and knowledge: Describe pathophysiology of conditions leading to laboratory abnormalities Integrate laboratory abnormalities into a diagnosis (or differential diagnoses) Know appropriate ancillary tests to further confirm definitive or differential diagnoses Interpret integrated laboratory results (biochemistry, urinalysis, serology, microbiology, immunodiagnostics, coagulation, hematology, etc.) TASK 4: Know the principles of commonly used laboratory instrumentation and methods Tested via non-image based MCQs ~5% of Phase II Knowledge: Analyzer and test procedure methodologies Sample types and collection methods Reference interval determination Errors and interferences (pre-analytical, analytic and post-analytical) Test properties (sensitivity, specificity, predictive values, ROC, etc.) and selection Quality control, quality assurance, biostatistics Routine, special and immunochemical stains Microscope principles, safety, biosafety TASK 5: Know pathophysiology and diagnosis of disease, with emphasis on manifestation in laboratory test data Tested via non-image based MCQs ~5% of Phase II, ~90% of Phase I Knowledge: Pathogenesis, etiology and organ-based causes for the following disease processes Genetic Disturbance of growth/neoplasia Cell aging/degeneration/injury/death Infection/immunity/inflammation 56

157 I2 Invention Phase Draft JTA Tasks Metabolic/Nutritional/Deficiency Hemodynamic/Vascular disease NON-TESTABLE TASKS (Currently listed on the CE Sponsor Verification Form) TASK 6 Compose and communicate interpretation and significance of results 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. 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). TASK 7 Know and Understand Quality Assurance Define standard operating procedures in accordance with prescribed methods in order to ensure acceptable levels of quality and consistency. Evaluate specimens, reagents, instruments, and personnel training by inspection, review and documentation in order to ensure the validity of data. 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. Blueprint Category Targets Distribution by Species S Domestic 70 80% S2 Lab animal 2 24% S3 Non-domestic 5 0% Distribution by Organ system O Hemolymphatic 20-25% O2 Skin/Integument 5-0% O3 Cardiovascular 2-6% O3 Gastrointestinal 5-0% O4 Pancreas, exocrine 2-6% 05 Liver 5-0% O6 Endocrine 5-0% O7 Renal 5-0% O8 Respiratory 2-6% O9 Nervous and special senses 2-6% O0 Musculoskeletal 2-6% O Reproductive 2-6% O3 Multiorgan/Systemic/Other 2-6% O4 Non-organ based 0-20% 57

158 I2 Invention Phase Draft JTA Tasks Distribution by topic (Phase II Examination) C Genetic 0 5% C2 Disturbance of growth/neoplasia 0 20% C3 Cell aging/degeneration/injury/death 5 0% C4 Infection/immunity/inflammation 30 40% C5 Metabolic/Nutritional/Deficiency 5 0% C6 Hemodynamic/Vascular disease 5 0% C7 Lab Analysis 0 20% Distribution by topic (also applied to the Phase I Examination) C Genetic 5 0% C2 Disturbance of growth/neoplasia 5 25% C3 Cell aging/degeneration/injury/death 5 0% C4 Infection/immunity/inflammation 40 60% C5 Metabolic/Nutritional/Deficiency 3 5% C6 Hemodynamic/Vascular disease 5 0% C7 Lab Analysis 3 5% DEFINITIONS Blueprint (test plan): The CE Blueprint is the document developed during the JTA and used by the Examination Committee to select CE content. The Blueprint is broken down by JTA Tasks and the following categories: species, organ system and disease process. It includes content percentage guidance based on the JTA. Certifying Examination Board (CEB): The CEB was constituted by Council in 20 and charged to evaluate all aspects of the certification process and to recommend to Council comprehensive strategies for maintaining and improving examination processes, in accordance with relevant best practices for professional certification. The CEB is currently composed of 20 ACVP diplomates. Eleven core members are appointed by Council and have voting stature. At least three core members must be certified in anatomic pathology and at least three must be certified in clinical pathology. Nine ad hoc members represent committees and activities related to the CE, including the Credentialing Committee, the Examination Committee, and the Training Program Committee. Other ad hoc members include the ACVP liaison to the ABVS, the ACVP secretary-treasurer, and one of the members who provide QA support to the Phase II CE. Examination Committee: Committee tasked with developing, administering and scoring the Certifying Examinations in Clinical Pathology and Anatomic Pathology. Tasks: Tasks are defined as the critical skills and knowledge expected of an entry level or minimally competent veterinary pathologist. 58

159 I2 Invention Phase Draft JTA Tasks Application of 5 Mapping Categories to Sample Test Items from the 203 Anatomic Pathology Examination Glass Slides: All CP glass slides will fall under Task Case Essays: All CP case essays will fall under Task 3. Rubeanic acid staining of hepatocyte intracytoplasmic granules indicates: A. Copper B. Glycogen C. Lipofuscin D. Hemosiderin Map: Task 4 2. In feline papillomavirus-associated squamous cell carcinomas, which protein has increased expression? A. p6 B. p2 C. p53 D. prb Map: Task 5 3. Cytologic identification of a kinetoplast helps identify: A. Cytauxzoon felis B. Neospora caninum C. Toxoplasma gondii D. Leishmania donovani Map: Task 5 4. In dogs, the following immunohistochemical profile from a skin mass suggests: Antibody Result CDa Positive CD4 Positive CDb Negative CDc Positive CD80 Positive E-cadherin Negative Thy- (CD90) Positive A. Histiocytic sarcoma B. Cutaneous histiocytosis C. Solitary cutaneous histiocytoma D. Hemophagocytic histiocytic sarcoma 59

160 I2 Invention Phase Draft JTA Tasks Map: Task 4 5. Both reticulocytes and mature erythrocytes have receptors for: A. Transferrin B. Fibronectin C. Complement D. Thrombospondin Map: Task 5 6. Which is the most likely cause of these laboratory abnormalities from an adult dog? Analyte Patient Reference Interval Serum iron (μg/dl) 30 L Serum TIBC (μg/dl) 75 L Stainable iron in marrow Increased Normal Serum ferritin (ng/ml) 350 H A. Hemolysis B. Inflammation C. Iron deficiency D. Corticosteroid administration Map: Task 3 7. In dogs, which condition is associated with botryoid neutrophils? A. Heat stroke B. Septic shock C. Hypersplenism D. High altitude disease Map: Task 5 8. In dogs, serum inhibin is a biomarker for: A. Transitional cell carcinoma B. Adrenocortical carcinoma C. Hepatocellular carcinoma D. Mammary carcinoma Map: Task 5 9. Which serum pattern is most consistent with tumor lysis syndrome? Uric acid Potassium Phosphorus Calcium A. Low High Low High B. High Low High Low C. Low Low Low High 60

161 I2 Invention Phase Draft JTA Tasks Map: Task 5 D. High High High Low 0. Which species has the lowest colostrum GGT activity? A. Horses B. Sheep C. Cattle D. Goats Map: Task 5. What is the best interpretation of this ADVIA cytogram from a dog? A. Leukocyte-platelet aggregates B. Neutrophilia with left shift C. Stage V lymphoma D. Rubricytosis Map: Task 2 6

162 R Refinement Phase Panel Participants YEAR OF CERTIFICATION Clinical Pathologists Practice Phd Training Name >5 Setting (Y/N) Program(s) Tan, Emmeline 2009 D, IDEXX N OVC N 2 Behling-Kelly, Erica 20 A, Cornell Y Wisconsin N 3 Freidrichs, Kristen 2003 A, Wisconsin N N 4 Santangelo, Kelly 202 A, CSU Y OSU N 5 Aulbach, Adam 2007 I, MPI N MSU/MPI N 6 Gupta, Ara 20 I, Merial N LSU N 7 Garner, Bridget 2009 A,UGA Y Misouri N 8 Collins, Nate 999 I, Celgene Y OSU N 9 Thompson, Craig 2005 A, Purdue N Okla State P 0 Shelley Burton 994 A, PEI Y PEI Y Bob Hall 982 I, Covance Y Ohio State, Colo State EC experience Y mid 80's I, Pfizer Y Colorado State N 2 Bill Reagan 3 Bounous, Denise? I, BMS Y Y 4 Scruggs, Jennifer 204 G, JPC Y Tenn N 5 Krimer, Paula 2002 D, AVDL (UGA) Y OVC N D: diagnostic laboratory A: academia I: Industry G: Government 62

163 R2 Refinement Phase Background Information Dear All, Thank you for agreeing to participate as a member of the ACVP Clinical Pathology Job Task Analysis (JTA) Refinement Committee. As I mentioned in my message last Friday, the purpose of the JTA is to define the knowledge and skills required of a minimally competent/entry level veterinary clinical pathologist for the purpose of determining content for the ACVP Certifying Examination. The attached document is titled Job Task Analysis, Clinical Pathology: Refinement Phase. The document defines JTA and describes the JTA process the College is using. It also provides some historical perspective relating to the JTA, starting with the the College Conducted in Finally, it includes draft knowledge and skills, defined as tasks, and certifying examination blueprint categories (species, organ system, disease topics) developed by a 20 member Invention committee. There are seven tasks, five of which are considered testable and two of which are nontestable. Following your review you will be asked, through an on-line survey, for your opinion regarding the importance of the draft tasks, the balance of items within blueprint categories, and whether or not you believe any critical tasks were overlooked. You will notice that we have asked you to include your name on the survey. We believe we need to be able to identify those who have completed the survey as a means to ensure there is appropriate demographic representation in this process. Only the three people responsible for administering the survey will see the names. We want and respect all opinions in this process, so please let me know if this is a problem for you. The link to the survey is: You will also be given the opportunity to participate in an optional GoToMeeting if you have questions/concerns/suggestions you would like to discuss with members of the Invention Committee and other members of the Refinement Committee. We have set-up two of these meetings, each at a different time of day in order to provide some flexibility in scheduling. Again, these meetings are optional. You can also contact me, Dorothee Bienzle or Glade Weiser directly with questions or concerns. I ve included the log-on information for both GoToMeetings below, following the Refinement Committee schedule. I have also included a call-in number, but I recommend you log-in through a computer, tablet or smart phone so you can take advantage of GoToMeeting features. Also as I mentioned in my message last week, let me know as soon as possible if you are unable to participate in this activity or if you would like me to contact you to discuss the JTA process. If you are unable to participate we will need to identify someone who fits your demographics to replace you; therefore, let me know as soon as possible if you can t participate. The survey completion deadline is 29 August. Keith JTA Clinical Pathology Refinement Committee Schedule 2/3 August with JTA draft skills/blueprint categories document and survey link sent to committee members 9 August, :00 PM CDT GoToMeeting conference call (optional) August, 9:00 AM CDT GoToMeeting conference call (optional) 29 August Survey completion deadline 63

164 R2 Refinement Phase Background Information ACVP Clinical Pathology Job Task Analysis Refinement Committee GoToMeeting Instructions August 9, 206, Tuesday 2:00 PM EDT :00 PM CDT 2:00 PM MDT :00 PM PDT Please join my meeting from your computer, tablet or smartphone. You can also dial in using your phone. United States : + (224) Access Code: August, 206, Thursday 0:00 AM EDT 9:00 AM CDT 8:00 AM MDT 7:00 AM PDT Please join my meeting from your computer, tablet or smartphone. You can also dial in using your phone. United States : + (408) Access Code: First GoToMeeting? Try a test session: 64

165 R3 Refinement Phase Questionnaire Membership Job Task Analysis - Clinical Pathology 65

166 R3 Refinement Phase Questionnaire 2. Do you agree with the proposed proportion of tasks on the phase II examination? Strongly agree Agree Disagree Strongly disagree TASK 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 clinical pathology ~5% TASK 3 Interpret and communicate clinicopathologic data from domestic and nondomestic animals ~25% TASK 4 Apply the principles of commonly used laboratory instrumentation and methods ~5% TASK 5 Apply knowledge of the pathophysiology and diagnosis of disease, with emphasis on manifestation in laboratory test data of animals ~5% If you chose "strongly" disagree, please elaborate. 66 2

167 R3 Refinement Phase Questionnaire 3. Are there critical tasks for entry level clinical pathologists omitted in this Job Task Analysis? If yes, indicate. Yes No Comment 4. What proportion of microscopy in your job as a Clinical Pathologist consists of interpretation of histology specimens (as opposed to cytology)? 0% -0% -25% 26-50% 5-00% 5. What proportion of microscopic interpretations in your job as a Clinical Pathologist utilize digital slides (as opposed to glass slides)? 0% -0% -25% 26-50% 5-00% 6. Do you have any concerns/suggestions for the Certifying Examination Board related to the JTA? 67 3

168 R3 Refinement Phase Questionnaire 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? or earlier 68 4

169 R4 Refinement Phase Survey Results Q Rate the extent to which an entry-level veterinary clinical pathologist should be able to perform a task Answered: 4 Skipped: 0 TASK Identify,... TASK 2 Recognize an... TASK 3 Interpret an... TASK 4 Know the principl... TASK 5 Know pathophysiol... TASK 6 Non-testable... TASK 7 Non-testable Not essential Moderately essential Essential Total Weighted Average TASK Identify, describe and interpret microscopic abnormalities in blood, bone marrow, body fluids, and tissues (cytology and histology) from domestic and non-domestic animals 0.00% % % TASK 2 Recognize and interpret static visual test results pertinent to veterinary clinical pathology 0.00% % % TASK 3 Interpret and communicate clinicopathologic data from domestic and non-domestic animals 0.00% % % TASK 4 Know the principles of commonly used laboratory instrumentation and methods. 0.00% % % TASK 5 Know pathophysiology and diagnosis of disease, with emphasis on manifestation in laboratory test data. 0.00% 0 7.4% 92.86% TASK 6 Non-testable activities: Compose and communicate interpretation and significance of results 0.00% % % TASK 7 Non-testable activities: Know and Understand Quality Assurance 7.4% 2.43% % # Comment Date Overall, I think in the point distribution and bit less emphasis on description and a bit more on interpretation would be a move in the right direction. 9/7/206 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). 8/28/206 8:52 PM / 7 69

170 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 be easier for me to judge whether particular/specific topics that fall within these Tasks are essential or non-essential. (As a side note, could a term such as "Important, but not essential" perhaps replace "moderately essential," as the latter is a bit hard to qualify. Or, perhaps only two categories are needed?) Also, how much overlap is allowed between/among Tasks? For example, Task 7 seems as though it could be included in Task 4. Related to this, I am not sure how Task 7, 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. 4 It seems like tasks 3 and have a lot of overlap with task 5. It will be hard to interpretate clin path data without understanding of the pathophys. Maybe incorporate task 5 into task 3 and task, and increase the relative percentages given to tasks 3 &. 5 I wrote moderately essential for task 2. While I think it is important for all clinical pathologists to interpret the significance of visual tests and to recognize some more routine images (special stains, QC data), I think asking image Qs on some - like a PARR gel or a microtiter plate reaction - is too specific for an entry level clinical pathologist. Those that work/research in these specific areas (like running PCR gels) will know those images but not necessarily the general candidate. Would be careful to scrutinize this section to be sure images asked about are not too esoteric. 8/22/206 :52 PM 8/22/206 :08 AM 8/8/206 :47 PM 2 / 7 70

171 R4 Refinement Phase Survey Results Q2 Do you agree with the proposed proportion of tasks on the phase II examination? Answered: 4 Skipped: 0 TASK Identify,... TASK 2 Recognize an... TASK 3 Interpret an... TASK 4 Know the principl... TASK 5 Know pathophysiol Yes No Total Weighted Average TASK 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 ~5% 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 ~5% TASK 5 Know pathophysiology and diagnosis of disease, with emphasis on manifestation in laboratory test data ~5% 85.7% % % 64.29% % % % % % % # Comment Date I have no concerns over the general distribution, but I have a question regarding task 5. If the bulk of the phase exam emphasizes laboratory test data, this seems to shift the focus of the general pathology portion away from basic disease pathogensis (this is an area I think we actually need to stress a bit more and try - although I completely understand how difficult this is- to move away from residents simply memorizing receptors and cytokines.) 9/7/206 9:49 PM 2 I may allocate 20% to TASK5 and 0% to TASK 4. 8/29/206 4:52 PM 3 Task : 35%; Task 2: 0%; Task 3: 35%; Task 4: 0%; Task 5: It's not clear to me how this would be approached to avoid overlap with some of the other sections. 4 I think greater understanding of pathophysiology is more important than knowledge of methodology and interpretation of static tests for a regular diagnostic setting. Learning methodology is easier to do on your own that learning pathophysiology (IMO). However, I don't feel very strongly about it. 8/22/206 :08 AM 8/9/206 3:2 PM 5 Task 4 should include method validation principles 8/9/206 3:20 PM 3 / 7 7

172 R4 Refinement Phase Survey Results 6 This proportion, with greatest emphasis on microscopic abnormalities, is skewed toward a diagnostic laboratory position. Given the large number of pharma and academic research positions, the proportion should at least be evenly weighted toward these roles. 8/9/206 2:48 PM 7 Recommend increasing the proportion for Task 5 to ~20% and reducing Task 4 to ~0% 8/9/206 2:45 PM 8 I think these proportions look very fair - would only recommend change - drop task 2 to ~0 % & 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. I think data interpretation is very important and deserves more %. 8/8/206 :47 PM 4 / 7 72

173 R4 Refinement Phase Survey Results Q3 Are there critical tasks for entry level clinical pathologists omitted in this Job Task Analysis? If yes, indicate. Answered: 4 Skipped: 0 Yes No 0% 0% 20% 30% 40% 50% 60% 70% 80% 90% 00% Answer Choices Yes No Responses 42.86% % 8 Total 4 # Comment Date Task 2, perhaps add serum protein electrophoresis. Task 3, add interpretation of study data/multiple animals in a data set. Task 4, add method validation. Task 5, cell based causes where applicable? 2 Not sure it is critical, but recognizing prenanalytical effects/artifacts of laboratory assays/data is important. It may be part of TASK 4? 3 Actually just a maybe. Laboratory management is required of the clinical pathologist by some companies that only have one clinical pathologist (so sometimes necessary at the entry level). This could be combined withtask 7. 9/7/206 9:49 PM 8/29/206 4:52 PM 8/28/206 8:52 PM 4 Overall, the Tasks adequately cover major broad topics. 8/22/206 :52 PM 5 There are probably myriad tasks and skills that are not listed but I don't think they should necessarily be expected of an "entry level" clinical pathologist. I suspect some may comment that the percentage breakdown for tasks in Q2 does not entirely reflect breakdown of tasks/competencies specific to certain jobs or sectors of the profession. But germane to the goal of JTA the proportions outlined seem perfectly reasonable when we consider expectations for newly minted diplomates, and would provide guidance for a base level of competency that could eventually be supplemented by on-the-job training or additional coursework, if needed. 6 I think verbal communication skills are important but can't be tested in this format. Also, there is no requirement for understanding their "client", usually a clinician. This may not be appropriate for this commentary, but residencies should require some understanding of the realities of being a clinician (and the impact their suggestions have on clinicians, owners and pets) by requiring at least 6 months of clinical practice. If I ran a residency program (anatomic or 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 to process it prior to submission? They may not have an opportunity after their residency to acquire that knowledge. 8//206 9:47 AM 8/9/206 3:2 PM 7 Validation principles 8/9/206 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't see it as it is currently listed. This is especally important in industry. 8/8/206 5:42 PM 9 I think that all areas are covered very well. 8/8/206 :47 PM 5 / 7 73

174 R4 Refinement Phase Survey Results Q4 Do you agree with the proposed species distribution for the Phase II examination? Answered: 3 Skipped: Domestic 70-80% Lab animal 2-24% Non-domestic (zoo, wildli Yes No Total Weighted Average Domestic 70-80% Lab animal 2-24% Non-domestic (zoo, wildlife, etc.) 5-0% 84.62% 53.85% % % % % 3.92 # Comment Date Lab animal should never be 24% of the exam - almost a /4 is too much. 8/22/206 :08 AM 2 While I agree that knowledge and experience in laboratory animals is important to pathology training, an upper percentage of 24% seems high given typical training at academic institutions associated with veterinary teaching hospitals. I think a high percentage of 5% would be more realistic. 3 I agree with the species distribution if the lab animal component is toward the lower end of the percentage range. I think it is excessive to have 24% lab animal and 0% non-domestic so that approximately /3 of the material is from these other species. A test comprised of approximately /3 material outside domestic realm would likely have to ask more detailed questions of those non-traditional species than is necessary for an entry level pathologist. 8/20/206 5:28 PM 8/0/206 :2 AM 4 I would likely equalize lab animal and non-domestic personally. I think 24% lab animal is high. 8/9/206 3:2 PM 5 Although I am biased coming from a toxicologic pathology environment, I feel the tox path/lab animal sector is growing rapidly and that the low end of the lab animal range (2%) is too low. A range of 8-25% feels better to me...giving a lower % for wildlife/zoo which I feel is probably not a growth sector with relatively limited job opportunities. 8/9/206 3:20 PM 6 See comments for question #2 above. 8/9/206 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 ~0-5 % maximum and put the rest into regular domestic animals if you want to reflect species many working clinical pathologists see.. 8/8/206 :47 PM 6 / 7 74

175 R4 Refinement Phase Survey Results Q5 Do you agree with the proposed distribution by organ system for the Phase II examination? Answered: 4 Skipped: 0 Hemolymphatic 20-25% Skin/Integument 5-0% Cardiovascular 2-6% Gastrointestina l 5-0% Pancreas, exocrine 2-6% Liver 5-0% Endocrine 5-0% Renal 5-0% Respiratory 2-6% Nervous/Special senses 2-6% Musculoskeletal 2-6% Reproductive 2-6% Multiorgan/Syst emic/other 2-6% Non-organ based 0-20% Yes No Total Weighted Average Hemolymphatic 20-25% 92.86% 3 7.4% 4.93 Skin/Integument 5-0% 92.86% 3 7.4% / 7 75

176 R4 Refinement Phase Survey Results Cardiovascular 2-6% Gastrointestinal 5-0% Pancreas, exocrine 2-6% Liver 5-0% Endocrine 5-0% Renal 5-0% Respiratory 2-6% Nervous/Special senses 2-6% Musculoskeletal 2-6% Reproductive 2-6% Multiorgan/Systemic/Other 2-6% Non-organ based 0-20% 92.86% % % % % % 85.7% % % % % % 3 7.4% % % % % % % % % % % % 4.93 # Comment Date Is urininary tract included as part of either renal and/or repro? Could be other as well- but if UAs and cytological samples are included that could be a 2-6% category. If multiorgan includes metabolic diseases (these may overlap with endocrine) I think that could be a bit higher. I am not sure where coagulopathies are falling (I would put them in this category as well and then uptick the percentage) 9/7/206 9:49 PM 2 Might up renal and lower nervous a bit. 8/29/206 4:52 PM 3 Would it be possible to get more clarification as to what falls into "non-organ" based versus "multiorgan/systemic/other"? 4 I agree wtih the general percentages but would prefer the lower end on special senses/nervous, reproductive and muskuloskeletal. In my experience, those samples aren't seen as commonly as the others. Someone fresh out should really 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. 5 Generally I agree with the proposed distribution. I suggest only minor changes in percentages based on the types of chemistry 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 5-0% and reduce GIT to 2-6%; lower percentage range for respiratory; at least the higher range for multiorgan to emphasize the integration of systems (primary and secondary effects of disease). 8/22/206 :52 PM 8/22/206 :08 AM 8/20/206 5:28 PM 6 GI percentage seems high and respiratory seems low. 8/0/206 :2 AM 7 I think endocrine should be much higher, definitely higher than GI. Clinical pathologists get a lot of questions about endocrine testing and this should be reflected in the organ system distribution. So much laboratory specialty testing is endocrine diseases. 8 The items hemolymphatic, liver, and renal Ive listed as "no" in my mind are the areas where clinical pathology assessment is a "relative" strength or value for the discipline. I feel at least for liver and renal, these ranges should be increased, possibly diminishing areas like neuro (little to no clin path value) or non-organ based (up to 20% seems high). 9 Propose increasing the distribution of liver and renal to ~5-20%. In drug development, these are most commonly involved/affected organs with respect to drug metabolism and excretion. 8/9/206 3:2 PM 8/9/206 3:20 PM 8/9/206 2:45 PM 8 / 7 76

177 R4 Refinement Phase Survey Results 0 Looks good but recommend increasing skin/integument & dropping cardiovascular a bit - CPs deal with a lot more skin diseases (especially tumor cytology) than cardiovascular. Could also drop reproductive a bit - at my college, we have minimal theriogenolgy work (we only interpret canine progesterone concentrations and may see vaginal cytolgogy a year) - the theriogenologists do all the rest. 8/8/206 :47 PM 9 / 7 77

178 R4 Refinement Phase Survey Results Q6 Do you agree with the proposed distribution of test items by topic for the phase I and phase II examination? Answered: 4 Skipped: 0 Genetic 5-0% Disturbance of growth/neopl... Cell aging/degene... Infection/immun ity/inflamma... Metabolic/Nutri tional/defic... Hemodynamic/Vas cular diseas... Lab Analysis 3-5% Yes No Total Weighted Average Genetic 5-0% Disturbance of growth/neoplasia 5-25% Cell aging/degeneration/injury/death 5-0% Infection/immunity/inflammation 40-60% Metabolic/Nutritional/Deficiency 3-5% Hemodynamic/Vascular disease 5-0% Lab Analysis 3-5% 7.43% % 85.7% % % 85.7% % % % % % % % % # Comment Date This question combines phase and phase 2, but I will answer relative to the breakdown listed in the JTA document that was sent out (slightly different numbers for the two phases). I would like to see more of C5 and C7 in phase 2. I think genetic diseases should be hit a bit harder in phase and less so in phase 2 (but this depends a bit on how the group is viewing the genetic questions- eg if it is simple recall of what gene/protein is involved vs something akin to explaining the hemoglobin curve shifts in PFK. I guess questions could fall under multiple categories as well?) 9/7/206 9:49 PM 2 What happened to toxicities? 8/28/206 8:52 PM 0 / 7 78

179 R4 Refinement Phase Survey Results 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 0-5%, infection/etc 40-50%, metabolic/nutritional ok, hemodynamic 0-5%, lab analysis ok. For phase II: genetic 5-0% is ok, growth/neoplasia 30-40, cell aging/degeneration 5-0% is ok, infection/etc 40-50%, metabolic/etc 5-0%, hemodynamic/vasc disease 0-20%, lab analysis 5-0%. 4 I think lab analysis (up to 5-5%) has to be higher because this is the particular domain of a clinical pathologist as they integrate and bring particular perspective during interactions with clinicians and anatomic pathologists. Reduce percentage applied to infection/immunity/inmflammation to make up the difference. Certainly questions relevant to neoplasia and infection may also be relevant to laboratory analysis. 5 Where would endocrine and hormonal disturbances fall on this list? Metabolic? In that case that category needs to be increased. 8/22/206 :08 AM 8/20/206 5:28 PM 8/9/206 3:2 PM 6 Do not understand the rationale for the majority of test items to be focused on infection/immunity/inflammation. 8/9/206 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 %. Would consider increasing the neoplasia % a bit and dropping genetic down if we are reflecting what diagnostic clinical pathologists see. The rest of the proportions look fine. 8/8/206 :47 PM / 7 79

180 R4 Refinement Phase Survey Results Q7 What proportion of microscopy in your job as a Clinical Pathologist consists of interpretation of histology specimens (as opposed to cytology)? Answered: 3 Skipped: 0-0% -25% 26-50% 5-00% 0% 0% 20% 30% 40% 50% 60% 70% 80% 90% 00% Answer Choices 0-0% -25% 26-50% 5-00% Responses 84.62% 7.69% 0.00% % Total 3 2 / 7 80

181 R4 Refinement Phase Survey Results Q8 What proportion of microscopic interpretations in your job as a Clinical Pathologist utilize digital slides (as opposed to glass slides)? Answered: 4 Skipped: 0 0-0% -25% 26-50% 5-00% 0% 0% 20% 30% 40% 50% 60% 70% 80% 90% 00% Answer Choices 0-0% -25% 26-50% 5-00% Responses 85.7% 2 7.4% 7.4% 0.00% 0 Total 4 3 / 7 8

182 R4 Refinement Phase Survey Results Q9 Do you have any concerns/suggestions for the Certifying Examination Board related to the JTA? Answered: Skipped: 3 # Responses Date Despite the limited requirement for histopathological evaluations in my day to day job (limited to bone marrow biopsies and the histopath samples we look at for follow-up purposes), having the extensive exposure I had as a resident I really think made me a better pathologist and I fear reducing this component of the exam would remove a major impetus for training programs and residents to be sure adequate exposure and experience with histopathology is part of the residency. I also don't know how this becomes a testable item- but somehow incorporating critical review of literature/primary data would be fantastic. Maybe scenarios with a glaring statistical or analytical error, omission of a control? Not overly nitty gritty- just can they identify a fatal flaw and not take that data/conclusion to the bank type stuff. 9/7/206 9:49 PM 2 no 8/29/206 4:52 PM 3 As mentioned, not sure why Task 7 isn't testable, but I would understand that laboratory management basics would not be testable. There appears to be some unavoidable overlap in tasks. Or perhaps it's just difficult differentiating them in short descriptions. But it would be difficult for me to map some questions given the current language. Having said that, I'm impressed with the work and grateful that this process is moving forward. 4 I would be interested in serving as a "test subject" or otherwise reviewing versions of the Phase I and Phase II examination. 8/28/206 8:52 PM 8/22/206 :52 PM 5 I think keeping some non-marrow histology slides on the exam is important. 8/22/206 :08 AM 6 The term "biostatistics" is vague. I actually don't know what you mean by that.do you mean precision vs. accuracy? 8/9/206 3:2 PM 7 no 8/9/206 3:20 PM 8 None 8/9/206 2:48 PM 9 Opted out to answer Q7 because I might be an outlier. My job is heavily based as an anatomic pathologist reading histology specimen. 8/9/206 2:45 PM 0 None other than the suggestion above about testing for assessing principles of method validation 8/8/206 5:42 PM No strong concerns - it looks like a lot of thought has gone into this and I am very pleased with the new changes to the certifying examination! The only thing I would urge is to not have the job task section percentages be overly controlling. For example, it would not be optimal if one had to include unusual or esoteric images or questions to meet a certain section quota. Therefore, I like the range of percentages (as noted here) for sections rather than a strict percentage - that allows flexibility and is wise. 8/8/206 :47 PM 4 / 7 82

183 R4 Refinement Phase Survey Results Q0 What is your employment sector? Answered: 4 Skipped: 0 Academia Diagnostic Laboratory Government Industry Other (zoo, conservation... 0% 0% 20% 30% 40% 50% 60% 70% 80% 90% 00% Answer Choices Academia Diagnostic Laboratory Government Industry Other (zoo, conservation, consulting, etc.) Responses 35.7% % 2 7.4% 42.86% % 0 Total 4 5 / 7 83

184 R4 Refinement Phase Survey Results Q When did you become certified in Veterinary Clinical Pathology? Answered: 4 Skipped: or earlier 0% 0% 20% 30% 40% 50% 60% 70% 80% 90% 00% Answer Choices or earlier Responses 28.57% % % 4 Total 4 6 / 7 84

185 R4 Refinement Phase Survey Results Q2 What is your name? Answered: 4 Skipped: 0 # Responses Date Erica Behling-Kelly Happy to expand, provide more detail is anything is unclear. Thank you for your efforts in this. 9/7/206 9:49 PM 2 Denise Bounous 8/29/206 4:52 PM 3 Bob Hall 8/28/206 8:52 PM 4 Kelly S. Santangelo 8/22/206 :52 PM 5 Jennifer Scruggs 8/22/206 :08 AM 6 Kristen Friedrichs 8/20/206 5:28 PM 7 Emmeline Tan 8//206 9:47 AM 8 Bridget Garner 8/0/206 :2 AM 9 Paula Krimer 8/9/206 3:2 PM 0 Adam Aulbach 8/9/206 3:20 PM Nathaniel Collins 8/9/206 2:48 PM 2 Aradhana Gupta DVM, MVSc, DACVP (Anatomic and Clinical Pathology), DABT 8/9/206 2:45 PM 3 William J. Reagan 8/8/206 5:42 PM 4 Shelley Burton 8/8/206 :47 PM 7 / 7 85

186 R5 Modified Task and Blueprint Document TASK AND BLUEPRINT LISTS AND CONTENT PERCENTAGES FOR CLINICAL PATHOLOGY TASK : Identify, describe and interpret microscopic abnormalities in blood, bone marrow, body fluids, and tissues (cytology and histology) from domestic and non-domestic animals Tested via glass slides and image-based MCQs ~30% of Phase II Skills and knowledge to: Write a coherent, organized descriptive report Summarize relative to the descriptive findings Interpretive conclusion(s) and/or diagnosis(es) List appropriate disease, condition, and/or differential diagnoses List potential causes(s) Describe associated changes in other organ Outline appropriate ancillary tests and anticipated results (e.g. special stains, immunohistochemistry, electron microscopy, PCR-based clonality, flow cytometry, cytology, other specialized laboratory tests in realms of biochemistry, serology, microbiology, immunodiagnostics) TASK 2: Recognize and interpret static visual test results pertinent to veterinary clinical pathology Tested via image-based MCQs ~0% of the Phase II Skills and knowledge for interpretation of: Hematology cytograms Flow cytometry plots Coagulation tracings Platelet aggregation plots Macroscopic hematology test results (eg. Coombs tests) Special and immunochemical stains Electron micrographs Quality assurance and quality control data. PCR clonality results TASK 3: Interpret and communicate clinicopathologic data from domestic and non-domestic animals Tested via case essays and MCQs ~30% of the entire Phase II exam. Skills and knowledge to: Describe pathophysiology of conditions leading to laboratory abnormalities Integrate laboratory abnormalities into a diagnosis (or differential diagnoses) Know appropriate ancillary tests to further confirm definitive or differential diagnoses 86

187 R5 Modified Task and Blueprint Document Interpret population laboratory data or study set data Interpret integrated laboratory results (biochemistry, urinalysis, serology, microbiology, serum protein electrophoresis, immunodiagnostics, coagulation, hematology, etc.) TASK 4: Apply the principles of commonly used laboratory instrumentation and methods Tested via non-image based MCQs ~0% of Phase II Using knowledge of: Analyzer and test procedure methodologies Sample types and collection methods Reference interval determination Errors and interferences (pre-analytical, analytic and post-analytical) Test properties (sensitivity, specificity, predictive values, ROC, etc.) and selection Quality control, quality assurance, relevant statistics Reference interval and method validation principles, relevant statistics Routine, special and immunochemical stains Microscope principles, Laboratory safety, biosafety TASK 5: Apply knowledge of the pathophysiology and diagnosis of disease, with emphasis on manifestation in laboratory test data Tested via non-image based MCQs ~20% of Phase II Using knowledge of: Pathogenesis, etiology and organ-based causes for the following disease processes Genetic Disturbance of growth/neoplasia Cell aging/degeneration/injury/death Infection/immunity/inflammation Metabolic/Nutritional/Deficiency Hemodynamic/Vascular disease TASK 6 Demonstrate knowledge of the basic mechanisms of disease Tested via non-image based MCQs 00% if Phase (See Phase I Topic Distribution below) Using knowledge of: Mechanisms fundamental to disease in animals, including principles of: o Cellular injury o Inflammation and repair o Hemodynamic disorders o Physical and chemical injury o Neoplasia 87

188 R5 Modified Task and Blueprint Document o Congenital and genetic diseases o Molecular pathology o Infectious processes o Immunology Mechanisms are general in nature in that they relate to most animal species NON-TESTABLE TASKS TASK 7 Compose and communicate interpretation and significance of results 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. 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). TASK 8 Demonstrate Proficiency in Laboratory Management and Results Release Quality Practices Define standard operating procedures in accordance with prescribed methods in order to ensure acceptable levels of quality and consistency. Evaluate specimens, reagents, instruments, and personnel training by inspection, review and documentation in order to ensure the validity of data. Evaluate data for evidence of pre-analytical and analytical error through inspection in order to determine if verification and troubleshooting are required to obtain reliable results. Demonstrate overall laboratory management aptitude Phase II Blueprint Category Targets Distribution by Species (Phase II) S Domestic 70 85% S2 Lab animal 0 5% S3 Non-domestic 5 0% Distribution by Organ system (Phase II) O Hemolymphatic, including coagulation 20 25% O2 Skin/Integument 6 2% O3 Cardiovascular 2 4% O3 Gastrointestinal 2 6% O4 Pancreas, exocrine 2 6% 05 Liver 2 5% O6 Endocrine 8 2% 88

189 R5 Modified Task and Blueprint Document O7 Renal, including urinalysis and urinary tract 5 20% O8 Respiratory 2 6% O9 Nervous and special senses 2 4% O0 Musculoskeletal 2 6% O Reproductive 2 4% O2 Non-organ based* 0 20% *Defined as mostly principles of laboratory technology, from selected items in Tasks 2 and 4. Distribution by topic (Phase II) C Genetic 5 0% C2 Disturbance of growth/neoplasia 20 30% C3 Cell aging/degeneration/injury/death ~5% C4 Infection/immunity/inflammation 25 35% C5 Metabolic/including endocrinopathy, acid base, 0 5% abnormal biochemistry C6 Hemodynamic/Vascular disease ~5% C7 Laboratory Technology 5 20% Phase I (General Pathology Blueprint) Distribution by topic (Phase I Examination targets, same for both Anatomical and Clinical Pathology) C Genetic 5 0% C2 Disturbance of growth/neoplasia 5 25% C3 Cell aging/degeneration/injury/death 5 5% C4 Infection/immunity/inflammation 35 55% C5 Metabolic/Nutritional/Deficiency 5 0% C6 Hemodynamic/Vascular disease 5 0% C7 Laboratory Technology 3 5% 89

190 V ACVP Newsletter JTA Description ACVP Newsletter September 206 Job Task Analysis Survey Coming in Late September In late September, all diplomates will receive an request to complete a short online survey. This survey is part of the College s ongoing Job Task Analysis (JTA) in support of the Certifying Examinations in Anatomic and Clinical Pathology. You will be asked to evaluate the appropriateness of key high level tasks required of an entry level/minimally competent veterinary anatomic and/or clinical pathologist. These draft tasks were generated by panels of diplomates earlier in the JTA process. The survey should not take more than 0 minutes to complete, and we hope that all diplomates will participate in this important activity, as data derived from the JTA will be used to develop content for our certifying examinations. Provided below is background information regarding the Job Task Analysis process. Background The American Board of Veterinary Specialties (ABVS) requires that each constituent specialty college or board conduct a Job/ Task Analysis (JTA) at least every 0 years. The ABVS defines a Job/Task Analysis as follows: Job/Task Analysis A systematic procedure for defining the tasks required by a job and the knowledge, skills, abilities, and other personal characteristics required of individuals performing that job. The results of a job/task analysis form the basis for determining the examination contents necessary to test mastery of that field. The ACVP conducted a (RDS) in , facilitated by Dr. Jim Henderson of Castle Worldwide. Results of this study were published in A test plan or test item blueprint was developed based on that study, and the Examination Committee (EC) mapped test items to the test plan beginning in 200. Successive ECs have revised the test plan to more accurately reflect exam content, while still adhering to the results of the RDS. The Certifying Examination Board (CEB) was formed in 20 and reviews the test plan annually. In 202, the test plan was evaluated in depth and modified by a subcommittee of the CEB with the support of Dr. Henderson and input from the Examination Committee. The College s subsequent decision in 205 to redesign the Phase II CE, with implementation in 207, prompted the need to conduct a new RDS. The CEB elected to use the terminology Job/Task Analysis (JTA) rather than RDS going forward, as the former is consistent with the terminology used by the ABVS. In 205, the CEB, in preparation for conducting the JTA and building on the data and conclusions derived from the 2009 RDS, developed draft key tasks performed by entry-level veterinary pathologists engaged in both specialties. In March 206, the CEB drafted a document outlining the JTA process, with an objective of completing this task and generating a blueprint for the 207 Phase II CE and the 208 Phase I examination by the 206 Annual Meeting. Although a Job/Task Analysis is a best practice for high stakes certifying examinations, there is no single method recommended for conducting this analysis (National Commission for Certifying Agencies Standards for the Accreditation of Certifying Programs, Standard 0). The CEB, with approval of ACVP Council, elected to conduct a JTA, building on the data collected from the RDS, the experience gained by the EC and the CEB over the last seven years working with the test plan based on that study, draft key tasks developed by the CEB, and the current CE test plan matrix. The CEB also recognized that the composition of the current examination, developed annually for over five decades by generations of Examination Committee members representative of the College at large, represents valuable historical data relative to CE content. The phases of JTA are as follows:. Invention (complete). This phase was conducted by the extended CEB, which is composed of core members appointed by Council and nine ad hoc members representing a number of ACVP committees, including the Examination, Training Program, and Credentialing committees. The objective of this phase was to confirm and refine key tasks performed by entry-level veterinary pathologists engaged in both specialties for subsequent levels of broader review. Also included in this stage of the process were draft CE test item percentages for each of the testable Tasks and for Blueprint categories of species, organ 90

191 V ACVP Newsletter JTA Description system, and process/topic. 2. Refinement (in process). In this phase, two panels, one for anatomic pathology (20 members) and one for clinical pathology (5 members), representing key demographics of the College, were asked to review the draft tasks and blueprint categories, and provide feedback to the CEB for refinement consideration. 3. Validation (late September/October 206). In this phase, the ACVP membership will have been asked to participate in a survey asking for a -3 level agreement on each item of the JTA. Members will also be asked to provide reasons for disagreements. Following its review of the membership survey results, the CEB will further refine the JTA. 4. Approval. The final document will be submitted to Council for approval. Following approval, the EC will use the Blueprint section of the JTA for CE development and mapping. ACVP News 9

192 V2 to ACVP Membership Describing Survey 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 4 member clinical pathology Refinement Committees. More detailed information regarding this process is available in the September 206 Newsletter: 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 0-5 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: Link to clinical pathology survey: 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 92 85

193 V2 to ACVP Membership Describing Survey KEY TASKS PERFORMED BY ENTRY LEVEL/MINIMALLY COMPETENT ANATOMIC PATHOLOGISTS TASK : Identify, describe and interpret microscopic conditions in domestic and non-domestic animals Tested using glass or virtual slide essays and MCQs ~40% of Phase II Skills and knowledge to: Write a coherent, organized histopathologic description 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.) TASK 2: Identify and interpret macroscopic conditions in domestic and non-domestic animals Tested via image-based MCQs ~20% of Phase II Skills and knowledge to: Give a morphologic diagnosis 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.) TASK 3: Interpret clinicopathologic data from domestic and non-domestic animals Tested via MCQs ~0% of the Phase II Skills and knowledge to: 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 93

194 V2 to ACVP Membership Describing Survey TASK 4: Apply knowledge of the pathophysiology, progression and diagnosis of disease in animals Tested via non-image based MCQs ~30% of the Phase II Using Knowledge of: 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 New and emerging diseases Well-recognized animal models of human disease Core concepts and current literature The integration of test results (microscopic, hematologic, biochemical, etc.) and clinical information TASK 5 Demonstrate knowledge of laboratory technology Tested via non-image based MCQs ~2% of the Phase II Using knowledge of: Principles of commonly used laboratory tests Quality assurance and quality control for laboratory tests TASK 6 Demonstrate knowledge of the basic mechanisms of disease Tested via non-image based MCQs 00% if Phase Using knowledge of: Mechanisms fundamental to disease in animals, including principles of: o Cellular injury o Inflammation and repair o Hemodynamic disorders o Physical and chemical injury o Neoplasia o Congenital and genetic diseases o Molecular pathology o Infectious processes o Immunology Mechanisms are general in nature in that they relate to most animal species NON-TESTABLE TASKS (Currently listed on the CE Sponsor Verification Form) TASK 7: Data Collection, Analysis and Interpretation Perform necropsies and collect gross morphometric data by weighing and/or measuring tissues, lesions, organs, whole animals, and other specimens in accordance 94

195 V2 to ACVP Membership Describing Survey with established protocols and using professional judgment in order to understand pathogenesis, diagnose disease, and/or perform quantitative data analysis. Review antemortem data and history using a systematic process in order to support the collection of relevant samples. Collect specimens and/or guide others in sample collection according to protocols or professional judgment for histology, cytology, and other testing for subsequent analysis or archiving in order to preserve sample integrity. Describe gross morphological observations using a systematic approach and appropriate, medical terminology in order to provide a complete and accurate record. 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. 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. TASK 8: 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 95

196 V3 Validation Phase Questionnaire Membership Job Task Analysis - Clinical Pathology 96

197 V3 Validation Phase Questionnaire 2. Do you agree with the proposed proportion of tasks on the phase II examination? Strongly agree Agree Disagree Strongly disagree TASK 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 clinical pathology ~5% TASK 3 Interpret and communicate clinicopathologic data from domestic and nondomestic animals ~25% TASK 4 Apply the principles of commonly used laboratory instrumentation and methods ~5% TASK 5 Apply knowledge of the pathophysiology and diagnosis of disease, with emphasis on manifestation in laboratory test data of animals ~5% If you chose "strongly" disagree, please elaborate. 97 2

198 V3 Validation Phase Questionnaire 3. Are there critical tasks for entry level clinical pathologists omitted in this Job Task Analysis? If yes, indicate. Yes No Comment 4. What proportion of microscopy in your job as a Clinical Pathologist consists of interpretation of histology specimens (as opposed to cytology)? 0% -0% -25% 26-50% 5-00% 5. What proportion of microscopic interpretations in your job as a Clinical Pathologist utilize digital slides (as opposed to glass slides)? 0% -0% -25% 26-50% 5-00% 6. Do you have any concerns/suggestions for the Certifying Examination Board related to the JTA? 98 3

199 V3 Validation Phase Questionnaire 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? or earlier 99 4