2.6.3.Selection of Cases

Anatomical Pathologists have viewed the diagnostic surveys as being educational rather than for proficiency testing or assessment of performance. The cases in the modules are selected to cover a wide range of pathologies including different organ systems in the general module and new entities, esoteric or difficult cases. Extensive reports including trends of an entity are provided to pathologists for their interest and ongoing education. The value provided to pathologists therefore, is far in excess of a basic proficiency testing program. Historically pathologists have enrolled in a number of specialist modules for their ongoing interest, but in the light of being assessed for performance and the false perception that individual pathologists will be assessed, Australian enrolments for 2012 have decreased.

The implications of the performance monitoring project are that:

• Selection of cases should be better suited to assessment of performance rather than educational value
• Inclusion of complex cases which may have been of particular interest needs to be reviewed and perhaps offered as a separate educational module
• By pathologists and laboratories decreasing their enrolments they may also be decreasing their exposure to cases they would not otherwise routinely see in daily practice.

Digital microscopy is now an internationally accepted medium for external quality assurance. Cases must be carefully selected to suit this medium. There have been several reports of poor image quality, slowness in using the Image Scope software and lack of familiarity with the software. It also is apparent that many laboratories do not have adequate technology to review the cases easily. A meeting has been convened on 27 June 2012, with the Australian agents of Aperio to assist the RCPA QAP in addressing these issues internally and for participants.