Cytopathology in focus: What pathologist competencies are monitored and how

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The final competency activity that was queried in this survey was the tracking of specific nongynecologic diagnostic category usage rates over time. Fifty-four percent of the laboratories (446 of 828) say they do track the use of specific nongynecologic diagnostic category rates over time; 40 percent (335) do not. Six percent (47) of respondents were unsure. Of the 439 respondents that indicated the level at which this tracking of nongynecologic diagnostic category usage rates over time is performed, 53 percent (233) of laboratories said they monitor and document this at the level of the individual; 78 percent (341) monitor and document at the level of the laboratory. Thirty-one percent (135) monitor it at the individual and at the laboratory level. Of 211 laboratories that responded to an additional question about whether an individual’s performance is compared with a benchmark or laboratory average, 83 percent (176) monitor individual pathologists to either a benchmark or a laboratory average.

The most frequently performed activities were a secondary review before sign-out for a first-time diagnosis of malignancy and both corrected/amended report activities, with 63 percent (526 of the 837 laboratories) performing all three activities. Additional analyses were performed to determine whether there were differences in the participation in pathologist competency activities by institution type. The only activity that showed a significant difference by this practice characteristic was the investigation of discrepancies between rapid on-site adequacy assessment and final diagnosis (Chi-square test; P < .001). Regional/local independent laboratories and national/corporate laboratories perform this activity less frequently than other institution types. Of the 38 national/corporate laboratories, only 37 percent (14) investigate these discrepancies, and only about half (35) of the 71 regional/local independent laboratories perform the investigations. These rates are significantly lower than for other practice types where 70 percent of laboratories (367 of 524) investigate the discrepancies between rapid on-site adequacy assessment and final diagnosis.

In summary, there is little available data regarding pathologist competency assessment, which prompted this CAP survey. Survey results highlight a variety of pathologist competency activities currently performed in addition to variable practices for monitoring and documenting these activities. The results provide a framework for a future study.

Dr. Booth, chair of the CAP Cytopathology Committee, is co-section head of cytopathology, Cleveland Clinic. Souers is a CAP senior biostatistician. Dr. Brainard, vice chair of the Cytopathology Committee, is vice chair of cytology operations, Cleveland Clinic.