Table 8.

Hematopathology Entrustable Professional Activity 7: Provide Guidance on Testing Parameters and Limitations for Routine Hematology, Ancillary, or Coagulation Testing.

Skills

Provide guidance on appropriate testing based on the clinical question and specimen and test characteristics

Troubleshoot discrepant/unusual/unreportable results and provide recommendations to laboratory staff and/or ordering provider

Develop laboratory protocols/procedures for commonly occurring test issues

Knowledge areas

Appropriate indications, technical requirements and techniques for routine and special hematology testing, special testing, flow cytometry immunophenotyping, cytogenetics, fluorescence in situ hybridization, immunohistochemistry, single and panel molecular testing, coagulation studies

Example scenarios

Troubleshoot and provide guidance on effects of interfering substances (eg, elevated bilirubin, hyperlipidemia, cryoglobulins, anticoagulation medication) on automated hematology and coagulation testing

Evaluate automated hematology analyzer flagging criteria, manual differential/pathologist review criteria

Detect and resolve platelet clumping (pseudo-thrombocytopenia)

ACGME Hematopathology Milestones version 2.0

Patient Care 1 and 4: Interdisciplinary consultation, specimen handling and triaging

Medical Knowledge 4 and 5: Selection of molecular and cytogenetics testing and interpretation of reports, clinical reasoning in hematopathology and hematology

Systems-Based Practice 3 and 5: Physician role in health care system, utilization

Practice-Based Learning and Improvement 1 and 2: Evidence-based practice and scholarship, reflective practice and commitment to personal growth

Professionalism 1, 2, and 3: Professional behavior and ethical principles, accountability and conscientiousness, self-awareness and help-seeking

Interpersonal and Communication Skills 2 and 3: Interprofessional and team communication, communication within health care systems

Abbreviation: ACGME, Accreditation Council for Graduate Medical Education.