ABOUT THE CEC SCHEME

Table of Contents

• Introduction
• Guidelines for In-House Co-Ordinators
• Registration
• Recording Individual CEC Activities
• Recording Group CEC Activities
• Data Feedback
• Questions and Answers
1. Compliance
2. NPAAC Requirements
3. Benefits of Participation
4. Benefits to Employers
5. Benefits to the Patient
6. Cytotechnologists out of work
7. Prior Approval of Credits
8. Supplementary Evidence of Learning Activities
9. Confidentiality
10. Part Time Cytotechnologists
11. Feed Back
12. When Can I Enrol
13. Supervision of Practical Classes
14. Supervising Examinations eg CT(ASC)
15. Backdating Diary Entries
16. Diary Recording is Time Consuming
17. Different Systems of Note Taking
18. Variation in Interpreting Categories
19. Internet Searches
20. Journal Searches
21. Multi-header Microscope Demonstrations
22. Workshop Preparation
23. Unusual Specimens
24. Credits for CT(ASC) and CT(IAC)

INFORMATION AND GUIDELINES

INTRODUCTION

This continuing education scheme has been designed by the Australian Society of Cytology for use by non-medically qualified persons engaged in the practice of diagnostic cytology. Its introduction provides both encouragement and a means by which we can all keep up to date and achieve best practice within our chosen discipline. The scheme is a product of research into an assessment of similar schemes in this and other countries and takes into account the diversity of educational background of the individual as well as laboratory size, location and complexity.

The process is essentially self driven. Upon registration with the scheme you will be provided with either a paper diary or access to the electronic version. The diary allows you to detail various forms of your continuing education, which can lead to the gaining of credit points. This is your individual responsibility. At half yearly intervals you will be required to submit data to the CEC Registrar for inclusion in the data base and to enable you to receive appropriate feedback.

Laboratories will need to identify a person, usually a local experienced cytology person, who can act as facilitator to encourage participation. The In House Co-Ordinator will help provide access to continuing education and offer local encouragement.

It is the responsibility of the individual not only to register but also to participate in the scheme and give the appropriate feedback to the Society. The facilitator has no responsibility to ensure compliance.

As the sponsor of the Scheme the ASC will act as a registry. The Society will provide the CEC diary and act as a data base gatherer of continuing education activities. Participants demonstrating successful compliance will receive a participation certificate together with a peer profile of continuing education activities.

The scheme is divided into groups of activities. Some can be initiated by you, eg journal reading, poster preparation, manuscript writing; and accessing Web site and other electronic teaching systems. Group activities include tutorial reviews and attendance at scientific meeting attendance etc. The scheme requires that you select a reasonable range of activities with activities selected from 4 out of 8 groupings.

The diary is arranged to provide you with a means of recording the details of all your continuing education activities. This part of the diary is for your own records. The diary also provides for a summary of credit points to be listed (Half Yearly CEC Activity Data Record Sheet). It the data contained in this section only that should be forwarded to the Registrar every six months.

The ASC will nominate from its membership a person to act as Registrar for the CEC scheme and this individual will be supported by a secretary. The Registrar will be the contact point as far as interpretation and implementation of the ASC scheme is concerned.

Persons who are registered with the scheme will receive a certificate of participation at the end of each year. The certificate will clearly indicate if the registrant has gained the minimum 600 points per annum.

For the program to be successful a local in-house experienced cytology person (medical or non-medical) should be available to act as a facilitator/mentor. It is envisaged that a single co-ordinator for each work place be nominated; the person selected may have an established role in quality control or staff education. The role of this person is to help direct candidates to sources of CEC both within and without the laboratory and make themselves available for general advice. There would be no obligation on the in-house co-ordinator to police the system, be involved in submitting information to the CEC Scheme or evaluating the feedback provided to an individual registrant. However the CEC Registrar should be informed of any problems arising with the CEC programme.

The following short notes are provided to help you get started and satisfy requirements for participation in the scheme.

Complete the Registration Form and send it to the CEC Registrar. If you are not a member of the ASC you should enclose a cheque for $170 made payable to the "Australian Society of Cytology Inc". The Registrar will then forward either your paper diary or enable you to gain access to the electronic version.

The diary contains a table summarising the credit points allocated for both individual and group activities and a means of recording your individual and group learning activities. Credits must be acquired from a minimum of FOUR of the total number of categories in any one year.

Recording Individual CEC Activities.

Select the code for the CEC category used. It is important to choose only one code for each activity and use separate entries to record each activity. Document the main reference or source of learning activity and enter a brief summary of what you have learned. Date the entry and calculate the number of credits gained. The following examples are provided for guidance:

Select code 1.

Document main reference/source of learning activity eg Title: "Endometrial Cells of the Lower Uterine Segment (LUS) in Cervical Smears Obtained by Endocervical Brushings: A Source of Potential Diagnostic Pitfall", Author: de Peralta-Venturino et al, Title of Source: Article, Year: 1995, Vol: 12, Pages: 263-271.

Write a brief summary of what you learned: LUS cells may be mistaken for endometriosis, squamous carcinoma in situ, endocervical glandular atypia, AIS, invasive adenocarcinoma and abnormal shedding of endometrial cells. Cytological features of LUS cells include glandular and stromal components, large tissue fragments often showing tubular/branching arrangements, feathering, gland openings, round nuclei with finely granular chromatin. Capillaries traversing the stromal fragments are characteristic.

Date: 7/11/97, CEC Category: 1, Credit Rating: 10, Duration (hrs): 0, Total Credits: 5.

Select code 4.

Document main reference/source of learning activity eg Title: "QAP Program (Cervical Cytology.", Author: RCPA, Title of Source: Quality assurance slide set 523, Year: 1997, Vol: not applicable, Pages: not applicable.

Write a brief summary of what you learned: Achieved a correct diagnosis in all cases except the smear from the 32 year old female. In retrospect should have called this CIN-3 as there were a few groups with scant cytoplasm and more worrisome nuclear features. Most of the cells were CIN-1, some showing wart virus effect.

Date: 7/11/97, CEC Category: 4, Credit Rating: 5, Duration (hrs): 0, Total Credits: 5.

Recording Group CEC Activities.

Select the number of the code for the CEC category used. It is important to choose only one code for each activity and use separate pages to record each entry. The following examples are provided for guidance:

Select code 7.

Document main reference/source of learning activity eg Presenter: Dr John Brown, Session title or topic: Effusion Cytology, Sponsor/Coordinator: not applicable, Date: 7/11/97, Venue: Seminar room 3.

Write a brief summary of what you learned: The features differentiating reactive mesothelials from mesothelioma were discussed. Features favouring mesothelioma include numerous clusters of tightly packed cells, increased size of cells and prominence of their nucleoli. On giemsa stained preparations the presence of a microvillus border and cytoplasmic blebbing is helpful. Collagen cores, confirming the true papillary nature of the tumour, are more commonly seen in mesotheliomas compared to metastatic adenocarcinoma.

Date: 7/11/97, CEC Category: 7, Credit Rating: 20, Duration (hrs):0, Total Credits: 25.

Select code 8.

Document main reference/source of learning activity eg Presenter: Dr Bloggs, Session title or topic: Respiratory Cytology, Sponsor/Coordinator: State Branch of ASC, Date: 7/11/97, Venue: Royal Hospital Lecture Theatre.

Write a brief summary of what you learned: Skills refined during the session include distinguishing reactive changes due to therapy from changes seen in malignancy; separating common infections and applying key cytological criteria for the diagnosis of common malignancies such as scc, adenocarcinoma and undifferentiated carcinoma.

Date: 7/11/97, CEC Category: 8, Credit Rating: 30, Duration (hrs): 0, Total Credits: 30.

At six monthly intervals complete the "Half Yearly CEC Activity Data Record" sheet. If you are using the paper diary take a photocopy for your file and forward the original to the CEC Registrar. For the electronic diary, the data will be electronically retrieved for analysis.

Firstly, we have attempted to design a user friendly system; one that has good flexibility so that it will be accepted and practiced equally by all, be they working in small isolated laboratories or larger metropolitan-based cytology units. We reasoned that as continuing education for health professionals has now become an expectation of government, the professions and even the public, this expectation would in itself be a major encouragement to enrol. While some continuing education schemes charge significant enrolment fees, the Society has decided that our scheme would be free to its members. (Non-members can expect to pay an annual enrolment fee in excess of the ASC membership fee). So here is another attraction to participate. Furthermore, we recognise the effort by way of an annual participation certificate.

Laboratory supervisors should document group activities, which form part of an in-house education programme in order to comply with this requirement and NATA accreditation. However it would not be their responsibility or would it be possible for them to document individual activities e.g. journal readings etc., or keep a diary of an individuals total activities (as the CEC diary does). Cytotechnologists are professionals and therefore have a responsibility to maintain the skills necessary for undertaking diagnostic cytology.

There are a number of benefits associated with participation in the scheme. These include formal recognition of activities that in the past were pursued on a personal basis; encouragement for individuals to maintain continuing education and keep abreast with colleagues; assist in the attainment of new knowledge and skills and in performance self appraisal; increased job satisfaction and provide an invaluable addition to ones Curriculum Vitae.

Enhanced quality of service by ensuring an up-to-date competent workforce who possess a broadened spectrum of skills and knowledge; satisfy requirements of NPAAC, NATA and other regulatory bodies; facilitate retention of staff by recognising the professionalism of individuals working in cytology and provide an aid in the recruitment process.

Major reviews of continuing education schemes in other disciplines have shown not only improved knowledge and performance of health professionals but also improved patient health status. It is envisaged that implementation of a similar scheme in cytology will result in improved quality of service as reflected in performance measures, cancer registry data and other indicators.

People who are unemployed for a period, for whatever reason, are unlikely to find a barrier because they lack immediate past enrolment in such a scheme. In the event that participation in continuing education is required by management, this could easily be addressed by employers recognising that a commitment to re-enrol by the individual could be a condition of employment.

Generally speaking, if by doing activities you learn or relearn some aspect of cytology, it should be acceptable. If in doubt you can ask your in-house co-ordinator for advice. It is a feature of our scheme that there is no provision for formal pre-assessment of activities by the A.S.C.

This is not a requirement, however if items such as course participation certificates are available, this would help you develop a more complete diary of your continuing education activity.

No, the diary is your record and only the A.S.C. has the right to see the content.

Firstly, we have agreed to allocate identical credit points for part-time or full-time employment (200 points). The flexibility of being able to chose any 4 out of 8 types of activity provides an opportunity to meet all varied work situations.

This will take two forms: Firstly, the Registrar will gather the Half Yearly CEC Activity Data from all enrollees and, at least once a year, you will be given a profile of your activity as compared to the peer group. Secondly, all participants will be issued with a certificate of participation for that year.

Enrolment can take place at any time of the year by completing the proper enrolment form and forwarding it to the Registrar. It is planned to regularly publish the enrolment form in Cytoletter. You will then be sent either your paper diary or access to the electronic version. The diary is designed to keep records for several years of continuing educational activity.

The time spent supervising students during a practical class would be considered a learning experience. This time can be claimed under Group CEC Activities (category 7 or 8 depending whether the class is internal or external).

No. There is no learning interaction between a student or supervisor during an examination. You can only claim for the educational activities you have been involved in while preparing the student for the examination.

The CEC cycle runs from January to December. Depending on when you join the scheme a pro-rata adjustment is made to your employment credits. A similar adjustment is made to the minimum annual requirement of points which is currently 600 credits for a full year. Consequently it is important that you only record learning activities from the date of registration.

If you feel you have not learned anything from a particular activity then you should state this. If you learnt a lot from an activity, then just list the most important points. It was never intended that you write extensive notes in the diary, otherwise more space would have been allocated per page. Just record enough "memory prompts" to facilitate recall at a later date. It you are reading extensively on a particular topic and the same learning points are being reinforced then just refer to the main diary page eg "see diary page entry for reference Acta Cytologica, 1995; 40: 23-25".

As mentioned above, list the pertinent points learned. Entries should not be a duplication of extensive notes documented elsewhere. You may want to consider setting up an additional folder, notebook or file where you store these comprehensive notes. After you list the pertinent points in the diary you may decide to refer to these lengthy notes as part of your diary entry.

The CEC Scheme has recently been revised and notes have been included to assist participants to select the correct category for recording their educational activities. Hopefully this will minimise some of the confusion that has been apparent in the first year of operation of the Scheme. We also need to remember that individuals who intentionally abuse the system are disadvantaging themselves. The scheme has not been designed to foster intense competition between individuals but to assist you in meeting your continuing educational responsibilities.

Yes. The time taken to search and collate this information is claimable under category 2 (Computer based learning activity). Those individuals who visit these sites at a later date for learning purposes can also claim under this activity.

As explained above, the time to search and collate this information is claimable. This educational activity should be claimed under category 5 (Literature search).

Yes. However, the teacher can only claim once for preparation of this material and this is claimed under category 5 (Teaching preparation or first time lecture). The teacher can claim for the time spent imparting his/her knowledge during each microscope session. The interaction that occurs during sessions such as these could be considered a learning experience for the person presenting the cases.

Yes. This activity can be claimed under category 5 (Teaching preparation or first time lecture). You could also claim for attendance at the workshop under category 8 (Workshop attendance) for the reasons outlined in the previous answer.

If it is the policy of the laboratory to offer these test then it is important staff have sufficient knowledge and expertise to perform these tests. Therefore, any educational activity associated with such tests would be claimable.

The current scheme does not recognise the attainment of qualifications. However all educational activities that assisted you in obtaining these particular qualifications can be recorded.