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Pathologist
Pathologist
Name
First
Last
Date
MM slash DD slash YYYY
Self-Assessment Rating Scale
No Experience
Theory or observation only during the past 12 months
Limited Experience
Performed less than 12 times within the past 12 months and may need a review
Experienced
Performed at least once per month within the past 12 months and may need minimal assistance
Highly Skilled
Performed on at least a weekly basis over the past 12 months; proficient
Specimen Processing (In the Absence of Grossing Assistant)
No Experience
Limited Experience
Experienced
Highly Skilled
Specimen receipt verification and labeling
Accessioning
Surgical Pathology
No Experience
Limited Experience
Experienced
Highly Skilled
Performing frozen sections
Using cryostat
Gross Description and Dissection of Specimens
No Experience
Limited Experience
Experienced
Highly Skilled
Large (major resections)
Medium (uterus/benign colon/etc.)
Small (gallbladder/hernia/sac/etc.)
Biopsies
Commonalities of Surgical and Autopsy Pathology
No Experience
Limited Experience
Experienced
Highly Skilled
Obtaining and submitting tissues for additional analytic procedures
Assisting in photographing gross and microscopic specimens
Autopsy Pathology
No Experience
Limited Experience
Experienced
Highly Skilled
Overall postmortem technique
Reviewing medical records
Developing preliminary autopsy diagnosis
Gross exam
Initiating and assisting performance of post-mortem examinations
Evisceration
Removal of brain and spinal cord
Exam findings
Other Skills
No Experience
Limited Experience
Experienced
Highly Skilled
LIS/HIS : Copath
Cerner
Requisition review
Voice recognition software
Appropriate selection of material for photographs
Billing processes/CPT coding
Signature
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