phlebotomy applied certificate program...prior learning assessment and recognition phlebotomy...

Phlebotomy Applied Certificate Program

PLAR Candidate Guide

Prior Learning Assessment and Recognition (PLAR)

Program PLAR Candidate Guide

Prior Learning Assessment and Recognition (PLAR)

Prior Learning Assessment and Recognition Ph lebotomy Program

Copyright

Saskatchewan Polytechnic No part of the work(s) contained herein may be reproduced or copied in any form or by any means – graphic, electronic, or mechanical, including photocopying, recording, taping of information and retrieval systems – without written consent of Saskatchewan Polytechnic.

The Phlebotomy program is dedicated to removing barriers and broadening the access to programs at Saskatchewan Polytechnic. We believe that adults acquire knowledge and skills through life and work experience that may align with courses within our programs.

Developed by program June 2017

Revised

Web ready – PLAR office

Revised template by

RPL office


Table of contents

Why consider a PLAR assessment? ...................................................................................... 4

What are the PLAR options? ................................................................................................ 4

Individual course challenge ............................................................................................. 4

Fees: ...................................................................................................................... 4

How many courses can be challenged through PLAR? ........................................................... 4

Which courses are PLAR-ready? .......................................................................................... 5

Is PLAR available at any time of the year? ............................................................................ 5

Is it easier to challenge a course through PLAR or take the course? ....................................... 5

Methods of assessing prior learning ..................................................................................... 5

If I live out of town, do I have to travel to a main campus to do PLAR? .................................. 6

What if I have a disability & need accessibility accommodations? ........................................... 6

Are there other ways to gain Saskatchewan Polytechnic credits for prior learning? ................... 6

Contact us ......................................................................................................................... 7

The PLAR process .............................................................................................................. 8

How long will it take to prepare evidence for PLAR? .............................................................. 9

Steps to complete a self-audit ............................................................................................. 9

Self-audit guides: Individual courses .................................................................................. 10

ETHC 185 – Professional Practices 1 ............................................................................... 10

INFC 180 – Infection Control and Safety ......................................................................... 13

MTER 180 – Medical Terminology ................................................................................... 16

PRAC 110 – Phlebotomy Practicum ................................................................................. 18

PROC 181 – Specimen Collection and Handling................................................................ 21

PROC 184 – Basic Specimen Processing .......................................................................... 24

Appendices ....................................................................................................................... 26

Appendix A – Employment validation form ...................................................................... 27

Appendix B – Employer validation checklists .................................................................... 28

ETHC 185 – Professional Practices 1 ........................................................................28

INFC 180 – Infection Control and Safety ..................................................................31

PRAC 110 – Venipuncture Practicum ........................................................................33

PROC 181 – Specimen Collection and Handling .........................................................37

PROC 184 – Basic Specimen Processing ...................................................................42

Professionalism Rubric ............................................................................................45

Appendix D – Exam Proctor form ................................................................................... 48

Appendix E – Cover page .............................................................................................. 49


Why consider a PLAR assessment?

PLAR refers to the combination of flexible ways of evaluating people’s lifelong learning, both formal and informal against a set of established standards. You can receive academic credit for your relevant lifelong learning. The Phlebotomy program recognizes prior learning in two ways:

Previous formal learning from an accredited training institution through transfer of credit.

Previous informal learning or experiential learning through a comprehensive prior learning and recognition process.

What are the PLAR options?

The following courses in the Phlebotomy program may be taken by continuing education or challenged through PLAR as an unclassified student prior to being admitted to the program. Completing program courses prior to admission has no impact on admission requirements but may reduce your course load if you are successfully admitted.

ETHC 185

INFC 180

MTER 190 To be eligible to register for any other courses in this program, whether through PLAR or continuing education, an applicant must first apply and be successfully admitted to the Phlebotomy program. Individual course challenge

If you have (within the last five years) successful experience in the Phlebotomy field, and have learned the skills and knowledge for one or more of the Phlebotomy courses, you may apply to be assessed for each applicable course. Fees:

There will be a charge for each individual course assessment.

For a listing of the specific PLAR fees for this program, open the online PLAR Inventory Database and search for the Phlebotomy program.

How many courses can be challenged through PLAR in the Phlebotomy program?

Currently we have 6 out of 6 certificate courses with PLAR challenges available. There is no limit. You may challenge as many of these courses as you are able to prove prior skills and knowledge through assessment.

https://webprod.siast.sk.ca:8000/ceroneprod/szpkplar.P_PLARInformation

https://webprod.siast.sk.ca:8000/ceroneprod/szpkplar.P_PLARInformation


Which courses are PLAR-ready?

Phlebotomy Program

Applied Certificate Program Profile

COURSE CODE COURSE NAME

PLAR Challenge(s) available

through program

PLAR Challenge(s) not available

ETHC 185 Professional Practices 1

INFC 180 Infection Control & Safety

MTER 180 Medical Terminology

PRAC 110 Venipuncture Practicum

PROC 181 Specimen Collection & Handling

PROC 184 Basic Specimen Processing

Is PLAR available at any time of the year?

PLAR challenges are currently being offered prior to start date of the course being challenged.

Is it easier to challenge a course through PLAR or take the course?

Neither is easier. By using PLAR you may reduce the repetition of studying information that you already know. The PLAR process allows you to demonstrate knowledge you already have. PLAR is not an easy way to certification, rather a “different” way to obtain certification. Your personal level of skill and experience will dictate which courses you choose to challenge. The self-audit section found later in this guide will help you decide if you have a good match of skill and knowledge for a specific course.

Methods of assessing prior learning

Assessment methods measure an individual’s learning against course learning outcomes. The PLAR assessment methods listed below are most commonly used, separately or in combination, to assess learning for Medical Diagnostic courses. Other forms of flexible assessment may be considered.

evidence files with requested documents

employment validations

employer validation checklists

challenge exams

performance evaluations (including skill demonstrations, role plays, clinical applications, case studies)

interviews and oral exams


equivalency (evaluations of learning from non-credit training providers)

All documents submitted to Saskatchewan Polytechnic may be returned to the student after the final results have been given and the grade appeal deadline of seven days has passed. A copy of transcripts and certificates may be included in your evidence file, but be prepared to show original documents at the PLAR audit meeting for validation.

If I live out of town, do I have to travel to a main campus to do PLAR?

There will be times that you will need to meet with the program on campus. However, we will try to keep travel to a minimum.

What if I have a disability & need accessibility accommodations?

At Saskatchewan Polytechnic, we understand that sometimes services must be provided to students in a variety of ways to achieve the goals of fair representation. Therefore, the range of services provided for students with disabilities is as diverse as the needs of those students. We strive for equity (not uniformity) and provide varied services for students with differing needs. If more information is required, please contact Accessibility Services. Are there other ways to gain Saskatchewan Polytechnic credits for prior learning?

Transfer Credit

Saskatchewan Polytechnic will grant credit for previous training that is similar in content, objectives, and evaluation standards to Saskatchewan Polytechnic training. Transfer of credit is different from the PLAR process. Transfer Credit guidelines may be found at: http://saskpolytech.ca/admissions/resources/transfer-credit.aspx It is the student’s responsibility to check with Registration Services for specific campus procedures on this policy. For specific information and guidelines regarding transfer of credit, contact a Saskatchewan Polytechnic educational counsellor. Equivalency Credit

Equivalency credit refers to the application of credit you may have earned in a previously taken Saskatchewan Polytechnic course to your current Saskatchewan Polytechnic course. Apply at registration services for equivalency credit. This process should also be completed prior to your PLAR challenge. If these credits cannot be used for equivalency credit, you may use these accredited courses as part of your evidence for your PLAR challenge.

http://saskpolytech.ca/student-services/support/accessibility-services.aspx

http://saskpolytech.ca/admissions/resources/transfer-credit.aspx

http://saskpolytech.ca/admissions/resources/contact-us.aspx

http://saskpolytech.ca/student-services/support/counselling-services.aspx


Contact us

If more information is required, please contact a counsellor at a campus closest to you. Saskatchewan Polytechnic in Moose Jaw Counselling Services, Room 2.203 306-691-8311 or 306-691-8310 [email protected]

Saskatchewan Polytechnic in Prince Albert Counselling Services, Room F203 (Technical Centre) 306-765-1611 [email protected]

Saskatchewan Polytechnic in Regina Counselling Services, Room 228 306-775-7436 [email protected]

Saskatchewan Polytechnic in Saskatoon Counselling Services, Room 114 306-659-4050 [email protected]

mailto:[email protected]





Prior Learning Assessment and Recognition process

Phlebotomy Applied Certificate courses which are not available to unclassified students may not be

challenged by PLAR until the student has applied and been successfully admitted into the Phlebotomy program. .

Consult with PLAR designated contact

Complete application to PLAR

Schedule PLAR audit meeting

Develop an action plan

Pay assessment fees

Prepare for prior learning assessment

Challenge facilitated by assessor

Challenge evaluated by assessor

Results submitted to Saskatchewan Polytechnic registration services

Candidate notified of results

call 1-866-467-4278 & speak with an education counsellor

identify goals

discuss process & forms

identify courses for challenge

meet with program head/faculty

review the self-audit

determine eligibility

obtain approval for PLAR

consult with program faculty responsible for each PLAR

confirm assessment methods &

procedures

follow an action plan

review your skills & knowledge

collect, create & compile evidence

obtain validations

meet timelines

Successful: see academic

transcript

Not successful: letter sent

consult with program head

register for course

grade appeal process available

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How long will it take to prepare evidence for PLAR?

Since the requirements are different for each course, and each candidate has different experiences, the amount of time it takes to prepare your evidence will vary.

Steps to complete a self-audit

1. Read through the levels of competence as listed below.

Mastery: I am able to demonstrate the learning outcome well enough to teach it to someone else.

Competent: I can work independently to apply the learning outcome.

Functional: I need some assistance in using the outcome.

Learning: I am developing skills and knowledge for this area.

None: I have no experience with the outcome.

Learning outcomes

For each learning outcome listed, please self-evaluate your competency levels and

record in the appropriate column for each self-audit.

2. Take a few minutes and read through the following self-audit for each course you are

interested in as a PLAR candidate. 3. Check your level of competence as you read through each of the learning outcomes for

each course. The information will help you in your decision to continue with your PLAR application.

4. In order to be successful in a PLAR assessment, your abilities must be at the competent or

mastery level for the majority of the learning outcomes. Some things to consider when determining your level of competence are:

How do I currently use this outcome?

What previous training have I had in this outcome: workshops, courses, on-the-job?

What personal development or volunteer experience do I have in this area?

Be prepared to explain the reason you chose this level if asked by an assessor.

5. Bring the completed self-audit to a consultation meeting with the program head or faculty

member in step 3 – PLAR process of the candidate process for prior learning assessment.


Self-audit guide(s)

ETHC 185 – Professional Practices 1

You will receive an introduction to health care and health care delivery systems. You will study the legal and ethical issues faced by health care professionals. You will discuss interpersonal and employability skills required in health care professions with an emphasis on teamwork, communication and stress management. You will learn methods to deal with grief and loss, in addition to skills and techniques for critical thinking and conflict management. Credit unit(s): 3.0 Equivalent course(s): HUMR 182


Mastery: I am able to demonstrate it well enough to teach it to someone else.

Competent: I can work independently to apply the outcome.



None: I have no experience with the outcome. Ma

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1. Describe health care and health care delivery.

Describe health and its determinants

Describe the components of Canada’s health care system

Describe the types of health care delivery

2. Describe legal and ethical issues in health care.

Describe the role and responsibilities of provincial and national professional associations

Define a hospital’s legal responsibility for providing a standard of care

Describe behaviour guidelines to minimize the risk of harassment,

slander and sexual abuse

Describe the components of a valid consent for treatment

Describe the importance of confidentiality in health care environments

Discuss professional ethics and bioethics

Describe mandatory reporting of suspected abuse and malpractice

Describe health care directives

3. Describe effective employability skills required in health care professions.

Identify the core skills for employability and professionalism

Identify the skills specific to Medical Diagnostics

Identify the importance of individual skill development

Identify strategies to develop employability skills and professionalism

4. Demonstrate interpersonal communication.

Describe the communication process








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Discuss how the communication process integrates effective verbal, non-verbal, listening and perception skills

Describe barriers to effective communication

Describe strategies to facilitate effective communication

Discuss the use of technology for communication

5. Explain how to facilitate communication with individuals having diverse needs.

Discuss communication for diverse needs

Describe techniques for effective communication when people have sensory impairments

Describe techniques used to communicate with impairments due to intoxication

Describe techniques used to communicate with mental impairments

Recognize diverse communication needs for patients of different

generations

Establish strategies for communicating across cultures and language barriers

Describe stressors affecting patients and how they affect behaviours

6. Demonstrate critical thinking skills.

Define critical thinking processes

Apply processes involved in critical thinking

Discuss the value of critical thinking

7. Describe stress and stress management strategies.

Describe the common stressors in life

Describe self-talk and how it relates to stress management

Describe a healthy balanced life

Describe stress reduction techniques

8. Describe the methods used when dealing with grief and loss.

Describe grief and the behaviour of individuals in various stages of grief

Describe how to assist patients in the various stages of the grieving

process








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Describe how grief affects the health care provider

9. Analyze the components of conflict and techniques for conflict management.

Describe conflict and views of conflict

Describe the conflict process

Discuss conflict management techniques

PLAR assessment methods

If you qualify for PLAR, you may be asked to demonstrate your learning in one or more of the following ways. Be prepared to discuss the expectations during a consultation meeting.

Challenge exam

Candidate is required to pass a 50 minute examination with a minimum mark of 50%

Candidate is tested on theory for both comprehension and critical thinking assessment

The closed book exam consists of multiple choice and case study questions

Upon prior approval of program head, complete a proctor form (refer to Appendix D).

** Candidate must pass challenge exam before the evidence file will be assessed **

AND

Evidence file (may or may not require an interview with assessor)

Completion of self-audit

Cover page (refer to Appendix E)

Signed employment validation form (refer to Appendix A)

Signed employer validation checklist (refer to Appendix B – ETHC 185)

If applicable, any relevant documentation of completion of private (offered as an in-service by past employers, for example), training courses, non-credit courses and/or workshops

Resources

A PLAR candidate may find it beneficial to review the following material in preparation for the assessment. The resources may be referred to, but are not required to PLAR the course.

Saskatchewan Polytechnic (current edition) ETHC 185 – Professional Practices 1, course manual, Saskatoon, SK: Saskatchewan Polytechnic Saskatoon Campus.


INFC 180 – Infection Control and Safety

You will study the transmission of microorganisms, blood-borne pathogens (i.e. hepatitis virus and HIV), standard precautions, isolation procedures, immunization for medical workers, sterilization and disinfection, biohazard waste, safety and WHMIS. Credit unit(s): 2.0







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1. Define the characteristics of microorganisms.

Describe the different types of microorganisms

Describe the appearance of bacteria

Describe the importance of endospores

Describe the phases of bacterial growth

Describe the viral characteristics and effects on host cells

2. Describe the interaction between microbe and host.

Describe normal flora

Describe host-microbial relationships other than normal flora

Describe the chain of infection

Describe the signs and symptoms of infection

Describe nosocomial infections, antibiotic resistant bacteria and the

role of infection control committees

3. Describe immunization and tuberculin testing.

Describe how immunity is achieved

Describe immunization practices for rubella, hepatitis and chicken pox

Describe the need for tuberculin testing

4. Describe the blood-borne pathogens – Hepatitis and AIDS.

Describe the transmission, pathology, diagnostic testing and treatment for Hepatitis A

Describe the transmission, pathology, diagnostic testing and treatment for Hepatitis B

Describe the transmission, pathology, diagnostic testing and

treatment for Hepatitis C

Describe the transmission, pathology, diagnostic testing and treatment for HIV








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Describe risks and exposure protocols for health care workers

5. Follow standard precautions and isolation procedures.

Describe the use and guidelines for standard precautions

Describe personal protection

Describe isolation procedures

6. Describe sterilization and disinfection procedures as an essential part of infection control.

Apply the correct terms used for sterilization and disinfection

Describe the various sterilization methods used in health care settings

Describe the various methods of chemical disinfection

Describe the various methods of mechanical disinfection

Describe aseptic technique

7. Describe safety and WHMIS in the workplace.

Describe the components of safety

Describe the components of WHMIS

Describe the disposal of waste in health care facilities


If you qualify for PLAR, you may be asked to demonstrate your learning in one or more of the following ways. Be prepared to discuss the expectations during a consultation meeting. Students enrolled in the Combined Laboratory and X-Ray Technology (CLXT), Cytotechnology, Medical Laboratory Assistant (MLA), Medical Laboratory Technology (MLT) and Medical Radiologic Technology (MRT) programs who successfully PLAR INFC 180 are required to participate in a Medical Diagnostic Department Saskatoon Campus laboratory safety tour as part of their program requirements. 1. Challenge exam


Candidate is tested on theory

The exam is closed book and consists of multiple choice questions

** Candidate must pass challenge exam before the evidence file will be assessed**


Upon prior approval of program head, complete a proctor form (refer to Appendix D).

AND 2. Evidence file (may or may not require an interview with assessor)




Signed employer validation checklist (Appendix B – INFC 180)

If applicable, any relevant documentation of completion of private (offered as an in-service by past employers, for example) training courses, non-credit courses and/or workshops

Resources

A PLAR candidate may find it beneficial to review the following material in preparation for the assessment. The resources may be referred to, but are not required to PLAR the course. Saskatchewan Polytechnic (current edition) INFC 180 – Infection Control and Safety, course

manual, Saskatoon, SK: Saskatchewan Polytechnic Kelsey Campus


MTER 180 – Medical Terminology

You will learn to use the prefixes, suffixes and combining forms from which medical terms are derived. You will also learn to use medical abbreviations. Credit unit(s): 1.0

Equivalent course(s): MED 161

MTER 180 - Medical Terminology






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1. Apply the rules for construction and analysis of medical terms.

State the components and combinations used

State the rules for word construction and analysis

State the rules for word pronunciation and spelling

2. Apply the rules for using medical suffixes, combining forms and prefixes.

Use suffixes which relate to medical conditions

Use suffixes which relate to technical procedures

Use general suffixes commonly used in the medical field

Use combining forms which relate to body systems

Use general combining forms that are commonly used in the medical field

Use prefixes which relate to direction or position

Use prefixes which relate to colour, shape, size or number

Use general prefixes that are commonly used in the medical field

3. Interpret medical abbreviations.

Interpret abbreviations and symbols related to pharmacy

Interpret abbreviations and symbols related to doctor’s orders

Interpret abbreviations and symbols related to measurement



If you qualify for PLAR, you may be asked to demonstrate your learning in the following way. Be prepared to discuss the expectations during a consultation meeting. 1. Challenge exam


The exam consists of multiple choice questions

The exam is closed book

Upon prior approval of program head, complete a proctor form (refer to Appendix D). Resources

A PLAR candidate may find it beneficial to review the following material in preparation for the assessment. The resources may be referred to, but are not required to PLAR the course. Saskatchewan Polytechnic (current edition) MTER 180 – Medical Terminology, course manual,

Saskatoon, SK: Saskatchewan Polytechnic Saskatoon Campus Several medical dictionaries and medical terminology textbooks are available at: Saskatchewan

Polytechnic Saskatoon Campus library

http://library.saskpolytech.ca/

http://library.saskpolytech.ca/


PRAC 110– Venipuncture Practicum

You will participate in a supervised clinical experience following the hours of work at a clinical site. Upon successfully completing this experience, you will be able to perform venipuncture. Credit unit(s): 4.0 Prerequisite(s): ETHC 185, PROC 181, PROC 184

PRAC 110 – Venipuncture Practicum






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1. Work safely in workplace.

Use standard precautions

Demonstrate lab hygiene practices

Use safety equipment

Respond to chemical and biological spills

Know all emergency codes

Respond to fire emergencies

Practice Global Harmonized Systems (GHS) guidelines

Describe protocol for incident/accident reporting

2. Review test requests.

Receive phlebotomy request

Ensure relevant information is present

3. Perform venipuncture techniques independently.

Identify according to protocol

Obtain consent

Perform venipuncture on patient

Follow correct protocol for blood exposure

4. Demonstrate ability to work as part of the phlebotomy team.

Determine work responsibilities

Perform duties as assigned

Assist co-workers in task completion

Work cooperatively with others

5. Demonstrate effective communication skills in phlebotomy.


PRAC 110 – Venipuncture Practicum






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Relate required information accurately

Record messages correctly

Demonstrate knowledge of telephone use (place on hold, transfer call)

Follow up on written and verbal requests promptly

Discuss ongoing work

Write clearly and concisely

6. Conduct all workplace actions in a professional manner.

Arrive on time daily

Adhere to dress code

Maintain confidentiality

Maintain code of professional conduct

Demonstrate time management, initiative and accountability

Work independently within limits of competence

Seek learning experiences to meet goals

Demonstrate ability to adapt to changes

Take responsibility for own actions

Adhere to policies and procedures of Saskatchewan Polytechnic and the health agency


If you qualify for PLAR, you may be asked to demonstrate your learning in the following way. Be prepared to discuss the expectations during a consultation meeting.

* You must have performed a minimum of 50 venipuncture collections within the last year in order to PLAR this course

(PRAC 110)*

1. Evidence file (may or may not require an interview with assessor)

Completion of self-audit (see above)



o The Employment Validation Form must indicate that the candidate has performed a minimum of 50 venipuncture collections within the last year in order to proceed with assessment


Signed employer validation checklist (Appendix B – PRAC 110)

If applicable, any relevant documentation of completion of private (offered as an in-service by past employers, for example) training courses, non-credit courses and/or workshops, i.e. WHMIS certification, TDG certification, WHMIS certification, TDG certification.

Resources

A PLAR candidate may find it beneficial to review the following material in preparation for the assessment. The resources may be referred to, but are not required to PLAR the course. Saskatchewan Polytechnic (current edition). PRAC 110 – Venipuncture Practicum Learner

Manual for Clinical Experience. Saskatoon, SK: Saskatchewan Polytechnic Saskatoon Campus


PROC 181 – Specimen Collection and Handling

You will learn to collect, handle and transport various laboratory specimens to ensure the quality of laboratory results. The collection of blood specimens will be emphasized. You will practice capillary and venous collection on adults at various sites in the community. Credit unit(s): 3.0

Prerequisite(s): INFC 180, minimum grade of 60%







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1. Collect blood samples by venipuncture.

Discuss phlebotomy and types of samples collected by venipuncture

Describe equipment used when performing venipuncture

Describe the venipuncture procedure

Discuss common situations, problems and special collections

Perform venipunctures on a variety of adult patients

2. Collect blood samples by capillary puncture.

Discuss capillary collection

Describe equipment used when performing capillary collections

Describe the capillary puncture procedure

Discuss common problems of capillary collection

Perform capillary punctures on adults

3. Explain the procedures for collecting and handling laboratory specimens other than blood.

Explain the collection and handling of urine for common laboratory

analyses

Explain the collection and handling of feces for common laboratory analyses

Explain the collection and handling of sputum for common laboratory

analyses

Explain the collection and handling of seminal fluid specimens for

common laboratory analyses

Discuss the handling of laboratory specimens typically collected by medical/nursing staff

4. Manage the receipt, distribution and storage of laboratory specimens.

Identify who must initiate a laboratory request

Assist with the receipt of specimens in the laboratory








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Assist with the accessioning of specimens

Assist with the preparation of serum and plasma samples

Prepare aliquot samples with supervision

Discuss the procedure for unsuitable specimens (e.g. unlabelled, mislabelled, wrong specimen collected, NSQ, etc.)

Discuss the distribution of specimens to appropriate testing areas

Discuss the storage and retention of specimens

5. Describe the transportation of laboratory specimens.

Discuss current legislation concerning transportation of biological

specimens


If you qualify for PLAR, you may be asked to demonstrate your learning in both of the following ways. Be prepared to discuss the expectations during a consultation meeting.

You must have performed a minimum of 50 venipuncture collections within the last year in order to PLAR this course

(PROC 181)*

1. Challenge exam

Candidate will be required to pass a 50 minute examination with a mark of 50% or more

Candidate is tested on theory for specimen collection and handling


The student may bring a non-programmable calculator into the exam

Upon prior approval of program head, complete a proctor form (refer to Appendix D)


AND





Signed employer validation checklist (Appendix B – PROC 181)

If applicable, any relevant documentation of completion of private (offered as an in-service by past employers, for example), training courses, non-credit courses and/or workshops.( i.e. WHMIS certification, TDG certification, WHMIS certification, TDG certification)


Resources

A PLAR candidate may find it beneficial to review the following material in preparation for the assessment. The resources may be referred to, but are not required to PLAR the course. Saskatchewan Polytechnic (current edition). PROC 181 – Specimen Collection and Handling,

course manual, Saskatoon, SK: Saskatchewan Polytechnic Saskatoon Campus


PROC 184 – Basic Specimen Processing

You will study the theory and practice required to perform basic specimen processing. You will focus on the use of centrifuges and transfer pipettes, specimen accessioning and aliquot techniques. Credit unit(s): 1.0

Prerequisite(s): INFC 180, MTER 180







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1. Describe the organization of a clinical laboratory.

Identify the various departments of a clinical laboratory and their role in

diagnostic testing

Identify the personnel of a clinical laboratory and the role they play

Discuss the testing process of a clinical laboratory

Discuss common tests performed in the Hematology Department

Discuss common tests performed in the Chemistry Department

2. Use basic laboratory equipment.

Explain safe laboratory practices

Discuss the use of a centrifuge

Explain transfer pipette skills

Demonstrate safe centrifuge and pipette skills

3. Practice accessioning and aliquoting of specimens.

Describe the process for requesting laboratory tests

Describe the process for receiving laboratory specimens

Discuss the composition of blood

Describe the procedures for preparation and distribution of specimens

Demonstrate specimen accession and aliquot skills



If you qualify for PLAR, you may be asked to demonstrate your learning in both of the following ways. Be prepared to discuss the expectations during a consultation meeting. 1. Challenge exam

Candidate will be required to pass a 50 minute examination with a mark of 50% or more

Candidate is tested on theory for Basic Specimen Processing


The student may bring a non-programmable calculator into the exam

Upon prior approval of program head, complete a proctor form (refer to Appendix D)


AND





Signed employer validation checklist (Appendix B – PROC 184)

If applicable, any relevant documentation of completion of private (offered as an in-service by past employers, for example), training courses, non-credit courses and/or workshops.( i.e. WHMIS certification, TDG certification, WHMIS certification, TDG certification)

Resources

A PLAR candidate may find it beneficial to review the following material in preparation for the assessment. The resources may be referred to, but are not required to PLAR the course. Saskatchewan Polytechnic (current edition). PROC 184 – Basic Specimen Processing course

manual, Saskatoon, SK: Saskatchewan Polytechnic Saskatoon Campus


Phlebotomy Applied Certificate Program

Appendices


Appendix A – Employment validation form

Phlebotomy applied certificate program

Prior Learning and Assessment and Recognition (PLAR)

Employment Validation Form

An essential part of prior learning and recognition is documentation that serves as evidence for the

Saskatchewan Polytechnic assessor that the employee/candidate has acquired skills and knowledge as they relate to the specific learning outcomes for the course(s) they are seeking credit. This

Employment validation form together with the appropriate employer validation checklist(s)

(Appendix B) provides an indirect, authenticated account of the employee/candidate’s performance in industry.

Employee/PLAR candidate: _________________________________________

(please print)

Employment information: (please print)

Employer: _________________________________________________

Employer address: __________________________________________

Employer phone number: ______________ Fax: _________________

Employer email: ____________________________________________

Dates of employment: _______________ to: ___________________ (dd/mm/yy) (dd/mm/yy)

Employment description: Full-time Hours per week: ___________

Part-time Hours per week: ___________

Job description (may be attached):

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Employer’s signature ___________________________ Date __________

Note to employee/PLAR candidate:

The information on this form must be completed and signed by your employer/supervisor or designate indicating the job description, place, and length of employment. This form, together with the appropriate

signed and dated employer validation checklist(s) (Appendix B) should be returned to our PLAR

assessor at Saskatchewan Polytechnic.


Appendix B – Employer validation checklists

Employer validation checklist: ETHC 185 – Professional Practices 1

Phlebotomy Student name:

ETHC 185 Student ID:

Professional Practices 1 Date:

Completion date: __________________

Note to validator: PLAR can be used to formally recognize learning that has already taken place. In the Medical Diagnostic programs at Saskatchewan Polytechnic Saskatoon Campus it is felt that recent

employment experience may constitute sufficient application of critical skills to meet the learning outcomes for Professional Practices 1.

Below is a list of learning outcomes the candidate is required to achieve in completing ETHC 185 (Professional Practices 1). For each step in the learning outcomes please rate the candidate’s

performance by placing a √ in the appropriate descriptor column (1, 2, 3, 4, none). For this validation if a parameter has not been performed by the candidate or is not a task that is performed at your

laboratory, please place a √ in the “none” column and provide a comment in the space provided at the

end of this document.

Please validate each of the learning outcomes for ETHC 185

then sign below and include with the employment validation form.


4: Exceeds the completion of work in an organized fashion within acceptable time frames, and displays the ability to apply concepts at an advanced level.

3: Consistently completes routine work in an organized fashion within acceptable time frames, and displays a good understanding of basic concepts.

2: Slow and/or disorganized and displays a lack of understanding in some basic concepts.

1: Consistently fails to complete routine work, disorganized and displays difficulty understanding basic concepts.

None: Has no experience with the outcome 4

3

2

1

No

ne

1. Demonstrates interpersonal communication by:

Seeking out and listening to colleagues and clients such as:

o approaching colleagues with questions about procedures and protocols

o following advice or direction given

o seeking advice when appropriate

Using effective verbal communication strategies such as:

o asking questions when information is not clear








3

2

1

No

ne

Using technology appropriately to facilitate communication such as:

o communicating appropriately while using the phone (i.e.

polite, professional)

o generating accurate computerized reports

Using effective written communication skills such as:

o writing neat and legible documents

o producing clear, organized and understandable written

documents

Following instructions well (verbal and written)

Demonstrating effective teamwork skills such as:

o working well with others involved in the same task, respecting their knowledge, skills and opinions

Demonstrating effective cooperative skills in dealings with others such as:

o offering to help/assist coworkers when own work is

completed

2. Demonstrates critical thinking skills by:

Performing appropriately in situations involving time

constraints, deadlines and unexpected events such as:

o using time effectively

o organizing work with limited assistance

Demonstrating effective behaviours in critical situations (identifies problems and offers solutions by:

o remaining calm and continuing to look for solutions even in stressful situations

Completes tasks, assignments and projects that involve new

skills in a timely and thorough manner by:

o approaching new challenges in a logical and enthusiastic manner

3. Demonstrates conflict resolution techniques by:








3

2

1

No

ne

Identifying their problem and unmet needs

Meeting and describing their problems and needs

Listening and considering the other person’s point of view

Negotiating a solution – willing to compromise

Following up on the solution

Asking for mediation/help if required

Comments: ______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________ Signature: ___________________________ Date: _______________________________


Employer validation checklist: INFC 180 Infection Control and Safety

Phlebotomy Student name:

INFC 180 Student ID:

Infection Control and Safety Date:

Completion date:

Note to validator: PLAR can be used to formally recognize learning that has already taken place. In

the Medical Diagnostic programs at Saskatchewan Polytechnic Saskatoon Campus it is felt that recent employment experience may constitute sufficient application of critical skills to meet the learning

outcomes for Infection Control and Safety.

Below is a list of learning outcomes the candidate is required to achieve in completing INFC 180

(Infection Control and Safety). For each step in the learning outcomes please rate the candidate’s performance by placing a in the appropriate column (yes or no). Candidate is expected to achieve a

“yes” on all criteria. For this validation if a parameter has not been performed by the candidate provide a

comment in the space provided at the end of this document.

Please validate the learning outcome for INFC 180

then sign below and include with the employment validation form.


Yes: Criteria met

No: Criteria not met Ye

s

No

Follow “Standard Precautions” and “Isolation Procedures” by demonstrating the following performance assessments.

Performance Test 1 (Removing gloves)

Uses one hand to pinch the wrist edge of the other glove

Pulls the glove downward, turning it inside out as it is removed and holds it in the gloved hand

Puts two finders of ungloved hand under the top edge of the other

glove, keeping the outer surface of the glove away from skin

Pulls the glove downward, turning it inside out, so that the glove being held is enclosed in the glove being pulled off

Discards gloves in appropriate garbage

Washes hands

Performance Test 2 (Removing gown)

Unties gown, waist ties first and neck ties last

Pulls neckline forward as neck is untied

Removes arms without touching outer surface of gown



Yes: Criteria met

No: Criteria not met Ye

s

No

Folds gown with outer surface in

Puts gown in appropriate laundry container or hangs it in appropriate area

Washes hands

Performance Test 3 (Hand washing)

Removes jewellery (rings, watches, bracelets, etc.)

Adjusts water flow and temperature

Wets hands thoroughly

Applies enough soap to give a lather

Scrubs all parts of hands including front, back, thumbs, nail beds, between fingers and wrists

Holds hands down, but not under water while scrubbing and adds more water if lather is not sufficient

Scrubs for a minimum of ten seconds.

Lowers hands under running water and allows water to flow from wrists

to fingers

Dries hands on paper towel

Uses paper towel to turn taps off

Comments: ______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________ Signature: _______________________________ Date:


PLAR Employer Validation Checklist: PRAC 110 – Venipuncture Practicum

Phlebotomy

PRAC 110

Venipuncture Practicum

Student name:

Student ID:

Date:

Completion date: _____________________

Note to Validator: PLAR can be used to formally recognize learning that has already taken place. In the Medical Laboratory Assistant Program at Saskatchewan Polytechnic Saskatoon Campus it is felt that recent

employment experience in a laboratory may constitute sufficient application of critical laboratory assistant skills to

meet the learning outcomes for the Venipuncture Practicum.

Below is a list of competencies the candidate is required to achieve in completing PRAC 110 (Venipuncture Practicum). For each step in the competencies please rate the candidate’s performance by placing a in the appropriate descriptor column (1,2,3,4, none). For this validation if a parameter has

not been performed by the candidate or is not a task that is performed at your laboratory, please place a in the “none” column and provide a comment in the space provided at the end of this document.

Please validate each of the competencies as well as the Professionalism Rubric for PRAC 110 then sign below and include with the employment validation form.

* The candidate must have completed a minimum of 50 venipuncture collections within the last year in order to PLAR this course (PRAC 110)*

Please verify the candidate has performed a minimum of 50 venipuncture collections within the last year:

If yes, continue with employer validation checklist

If no, return form to candidate indicating in the comment section that this criteria was not met

Yes or No

PRAC 110 – Venipuncture Practicum 4: Exceeds the completion of work in an organized fashion within acceptable time

frames, and displays the ability to apply concepts at an advanced level.

3: Consistently completes routine work in an organized fashion within acceptable time

frames, and displays a good understanding of basic concepts.

2: Slow and/or disorganized and displays a lack of understanding in some basic

concepts.

1: Consistently fails to complete routine work, disorganized and displays difficulty

understanding basic concepts.

None: Has no experience with the outcome. 4

3

2

1

No

ne

Competency 1: Performs venipuncture collection to obtain

appropriate samples for laboratory analyses.

The candidate shall perform to the following standards:

Perform six venipuncture collections within one hour

Demonstrate knowledge for performing:







concepts.




3

2

1

No

ne

o Blood cultures

o Legal alcohols

o Glucose tolerance administration

o Intervenous therapy collections

Pre-procedural:

o Identifies self by name

o Requests patient consent

o Asks for spelling of last name & date of birth

o Checks inpatient wristband (when applicable)

o Explains each procedure to the patient (e.g. tourniquet, alcohol,

puncture, etc.)

Tourniquet:

o Is applied in proper place and tightened appropriately

o Application does not exceed 1 minute

o Is removed before needle removal

Demonstrates aseptic techniques by:

o Cleansing site in concentric circles

o Cleansing palpating finger

o Allowing alcohol to air dry without drying with gauze/cotton

Anchors vein appropriately

Vacutainer holder is held appropriately, firmly and is stable during insertion and removal of tubes

Needle insertion:

o Bevel facing up

o Smooth quick insertion

o Needle angle and depth are correct

o Needle adjustments are made appropriately

Chooses appropriate tubes and follows correct order of draw

Obtains all required specimen tubes successfully

o Fills all tubes to appropriate level







concepts.




3

2

1

No

ne

o Ensures specimens are fully and appropriately mixed

Needle Removal

o Tube is removed prior to needle removal

o Dry cotton is placed on puncture site, needle is withdrawn and appropriate pressure is applied

Labels specimen in front of patient

Demonstrates patient care techniques:

o Releases fist once blood flow is established

o Ensures puncture site has stopped bleeding

o Asks patient if they want a Band-Aid

o Responds appropriately to adverse patient reactions

o Thanks patient

Ensures collection time, date and phlebotomist initials are recorded

Demonstrates safe work practices

o Utilizes personal protective equipment

o Applies standard precautions

o Safety engineered device (SED) is applied immediately using a

one-handed technique

o All sharps are discarded immediately in a sharps container utilizing multi-sample holder appropriately

o Tube tops are bleached

o Performs all steps required for phlebotomy safely and independently

Transport of specimens

o Prepares and transports all specimens to analysis area according

to laboratory protocol

Identifies errors in procurement

o Identifies and reports errors in specimen procurement

o Identifies corrective action for procurement errors

Meets the legal and ethical requirements of practice and protects the

patient’s right to the established level of care







concepts.




3

2

1

No

ne

Demonstrates effective interpersonal communication skills with

patients, co-workers and other health professionals in the workplace

Conducts professional practice according to established protocols, safety guidelines and existing legislation

Interacts in a professional and competent manner, using effective listening, verbal and written communication in dealing with laboratory

colleagues, patients, students, clients, and other health professionals

Comments:

Signature: _______________________________ Date:

The Professionalism Rubric evaluates professional skills required to be successful in the workplace and is

based on Employability Skills identified by the Conference Board of Canada. The completion of the

Professionalism Rubric is a part of the Employer Validation Checklist for PRAC 110.


PLAR Employer Validation Checklist: PROC 181 – Specimen Collection and Handling

Phlebotomy

PROC 181 Specimen Collection and Handling

Student name:

Student ID:

Date:

Completion date: _____________________

Note to Validator: PLAR can be used to formally recognize learning that has already taken place. In the

Medical Diagnostic programs at Saskatchewan Polytechnic Saskatoon Campus it is felt that recent employment experience in a laboratory may constitute sufficient application of critical laboratory skills to meet the learning

outcomes for Specimen Collection and Handling.

Below is a list of learning outcomes the candidate is required to achieve in completing PROC 181 (Specimen

Collection & Handling). For each step in the learning outcomes please rate the candidate’s performance by placing a √ in the appropriate descriptor column (1, 2, 3, 4, none). For this validation if a parameter has not

been performed by the candidate or is not a task that is performed at your laboratory, please place a √ in the

“none” column and provide a comment in the space provided at the end of this document.

Please validate each of the learning outcomes for PROC 181 then sign below and include with the employment validation form.

The candidate must have performed a minimum of 50 venipuncture collections

within the last year in order to PLAR this course (PROC 181)*

Please verify the candidate has performed a minimum of 50 venipuncture collections within the last year:

If yes, continue with employer validation checklist If no, return form to candidate indicating in the comment

section that this criteria was not met

Yes or No

PROC 181 – Specimen Collection & Handling






3

2

1

No

ne

1. Collect blood samples by venipuncture.

The candidate shall perform venipuncture collections to the following standards:

Pre-procedural:



o Asks for spelling of last name, date of birth & checks inpatient

wristband








3

2

1

No

ne


puncture, etc.)

Tourniquet:




wristband



o Cleansing palpating finger


Anchors vein appropriately

Vacutainer holder is held appropriately, firmly and is stable during insertion

and removal of tubes

Needle insertion

o Bevel facing up

o Smooth quick insertion

o Needle angle and depth are correct

o Needle adjustments are made appropriately

Chooses appropriate tubes and follows correct order of draw

Obtains all specimens successfully


o Ensures specimens are fully and appropriately mixed

Needle removal

o Tube is removed prior to needle removal

o Dry cotton is placed on puncture site, needle is withdrawn and

appropriate pressure is applied

Labels specimen in front of patient

Demonstrates patient care techniques

o Releases fist once blood flow is established


o Asks patient if they want a Band-Air (if applicable)


o Thanks patient








3

2

1

No

ne

Ensures collection time, date and phlebotomist initials are recorded




o Safety engineered device (SED) is applied immediately using a one-

handed technique

o All sharps are discarded immediately in a sharps container utilizing

multi-sample holder appropriately

o Tube tops are bleached



o Prepares and transports all specimens to analysis area according to

laboratory protocol






Demonstrates effective interpersonal communication skills with patients,

co-workers and other health professionals in the workplace

Conducts professional practice according to established protocols, safety

guidelines and existing legislation

Interacts in a professional and competent manner, using effective listening,

verbal and written communication in dealing with laboratory colleagues,

patients, students, clients, and other health professionals

2. Collect blood samples by capillary puncture.

The candidate shall perform a capillary collection to the following standards:

Pre-procedural:




wristband


puncture, etc.)









3

2

1

No

ne



Performs an appropriate “squeeze” technique


o Ensures specimens are fully and appropriately mixed (no clots detected)

Demonstrates patient care techniques:


o Asks patient if they want a Band-Aid (if applicable)


o Thanks patient

Ensures collection time, date and phlebotomist initials are recorded and

marks the requisition as a capillary collect5ion




o All sharps are discarded immediately in a sharps container

o Disinfects all blood droplets



o Prepares and transports all specimens to analysis area according to

laboratory protocol






Demonstrates effective interpersonal communication skills with patients,

co-workers and other health professionals in the workplace

Conducts professional practice according to established protocols, safety

guidelines and existing legislation

Interacts in a professional and competent manner, using effective listening,

verbal and written communication in dealing with laboratory colleagues,

patients, students, clients, and other health professionals

3. Demonstrate knowledge of the procedures for collecting and handling

laboratory specimens other than blood to include:








3

2

1

No

ne

The collection and handling of urine for common laboratory analyses

The collection and handling of feces for common laboratory analyses

The collection and handling of sputum for common laboratory analyses

The collection and handling of seminal fluid specimens for common

laboratory analyses

The handling of laboratory specimens typically collected by medical/nursing

staff

4. Manage the receipt, distribution and storage of laboratory specimens

The candidate shall demonstrate knowledge of the receipt, distribution and

storage of laboratory specimens by:

Identifying who must initiate a laboratory request

Assisting with the receipt of specimens in the laboratory

Assisting with the accessioning of specimens

Assisting with the preparation of serum and plasma samples

Preparing aliquot samples with supervision

Discussing the procedure for unsuitable specimens (e.g. unlabelled,

mislabelled, wrong specimen collected, NSQ, etc.)

Discussing the distribution of specimens to appropriate testing areas

Discussing the storage and retention of specimens

5. Describe the transportation of laboratory specimens.

Demonstrate knowledge of current legislation concerning transportation of

biological specimens

(If candidate is able to provide copies of TDG certification and WHIMS training

they have met the criteria for learning outcome 5)

Comments:

Signature: _______________________________ Date:


PLAR Employer Validation Checklist: PROC 184 – Basic Specimen Processing

Phlebotomy

PROC 184 Basic Specimen Processing

Student name:

Student ID:

Date:

Completion date:

___________________________

___________________________

___________________________

___________________________

Note to Validator: PLAR can be used to formally recognize learning that has already taken place. In the Medical Diagnostic programs at Saskatchewan Polytechnic Saskatoon Campus it is felt that recent

employment experience in a laboratory may constitute sufficient application of critical laboratory skills to meet the learning outcomes for Basic Specimen Processing.

Below is a list of learning outcomes the candidate is required to achieve in completing PROC 184 (Basic

Specimen Processing For each step in the learning outcomes please rate the candidate’s performance by

placing a √ in the appropriate descriptor column (1, 2, 3, 4, none). For this validation if a parameter has not been performed by the candidate or is not a task that is performed at your laboratory, please place a

√ in the “none” column and provide a comment in the space provided at the end of this document.

Please validate each of the learning outcomes for PROC 184 then sign below and include with the Employment Validation Form.







3

2

1

No

ne

Competency 1: Demonstrate specimen accessioning and aliquoting skills.

The candidate shall perform specimen accessioning and aliquoting skills to the

following standards:

Centrifuging

- Uses centrifuge appropriately

- Solution is completely separated

- Precipitate has not been disturbed

- Supernatant does not contain precipitate

- Centrifuges appropriate samples

- Centrifuges samples at an appropriate time and speed

Pipetting

- Uses transfer pipette to remove supernatant

- Holds pipette properly and securely








3

2

1

No

ne

- Pipette tip does not disturb precipitate

- Consistently holds pipette tip against receiving vessel when transferring solution

- Uses a clean pipette for each transfer

- No bubbles are in aliquot

- Correct sample is transferred

Accessioning /Data entry

- All data is entered onto the accessioning log

- All tests are recorded accurately and in the correct department

- Accession number is accurately recorded on the requisition


- Utilizes personal protective equipment

- Uses biohazard safety shield correctly

- Samples are transported in a tube rack

- Discards pipettes/glassware appropriately

- Disposes of waste according to lab protocol

- Cleans work station

- Consistently follows laboratory protocols, (i.e. PPE, hand hygiene, disposal, etc.)

Patient Identification

- Patient information is printed clearly

- Patient information is recorded in ink

- All patient information is completely legible

- All patient information is corded fully and accurately in the accession log or through LIS

- Patient information is accurate on all samples

Labeling

- Accession number is accurately recorded on all appropriate samples

- Stat, Urgent and ASAP priority is indicated on samples as appropriate

- Appropriate sample type (i.e. anticoagulant, plasma or serum) is accurately indicated on each aliquot/sample as required

- Appropriate tests requested are recorded on the sample to be tested (primary/aliquot)


Comments:

Signature: _______________________________ Date: ___________________________________


Professionalism Rubric

Candidate: _____________________________________________ Date: _______________________

Scoring For each skill below: 1 – Skill is consistently demonstrated 0.5 point – Skill is usually

demonstrated 0 – Skill is rarely demonstrated

Category Skill 1 Skill 2 Skill 3 Skill 4 Score

1.0. Demonstrates

communication

skills.

1.1. Reads and comprehends

information presented in a variety of forms. (e.g. reads

requisitions)

/1

1.2. Follows directions (oral

and written).

/1

1.3. Asks relevant questions.

/1

1.4. Writes and speaks so

others comprehend. (e.g. provides clear instructions

to patients/colleagues.)

/1 /4 2.0. Demonstrates

organizational skills.

2.1. Locates and gathers

information using available resources. (e.g. LIS, RIS,

PACS, procedure manuals,

history records, technology, reference books, patient.)

/1

2.2. Organizes materials and

documents. Maintains a clean, organized

workspace.

/1

2.3. Demonstrates effective

time management.

/1

2.4. Demonstrates ability to

multi-task.


professional

behaviours.

3.1. Demonstrates empathy and

respect for patients and/or patient information.

/1

3.2. Acts with honesty and

integrity.

/1

3.3. Upholds health region’s

confidentiality policy.

/1

3.4. Takes responsibility for

one’s actions.


positive

behaviours.

4.1. Complies with Medical Diagnostics Department

attendance regulations.

/1

4.2. Complies with Medical Diagnostics dress code.

/1

4.3. Displays interest and effort towards learning

new skills.

/1

4.4. Conducts self in a confident positive manner.


initiative and

adaptability.

5.1. Takes initiative and pursues procedures or extra tasks.

/1

5.2. Takes responsibility for learning.

/1

5.3. Requests and responds professionally to

feedback received. /1

5.4. Demonstrates ability to problem solve.

/1 /4

6.0. Demonstrates

safe work practices.

6.1. Utilizes personal protective

equipment.

/1

6.2. Incorporates all steps

required for a safe and successful outcome.

/1

6.3. Performs tasks within

scope of practice.

/1

6.4. Applies infection control

and/or safety measures.


teamwork.

7.1. Works cooperatively within the health care system.

/1

7.2. Respects the contributions and concerns of

preceptors, facilitators and other health care

professionals. /1

7.3. Respects the diversity and differences of

others.

/1

7.4. Collaborates and shares ideas with team members.

/1 /4


Total /28


Instructions for Completion:

The Professionalism Rubric evaluates professional skills required to be successful in the workplace and is based on Employability Skills identified by the Conference Board of Canada. Each Category is marked out of a total of 4 points. Pass mark for the Rubric is 60%. Each Skill within the category will be scored 1 if skill is consistently demonstrated, 0.5 if skill is usually demonstrated or 0 if skill is

rarely demonstrated. Definitions: Consistently- reliably, unfailingly, constantly;

Usually- typically, frequently, ordinarily; Rarely- seldom, infrequently

A comment is required when a rating of zero is recorded. Record the date the rubric was reviewed with Learner.

Additional Comments:

Assessor name & contact information (print) Signature

Date:

© SaskPolytech March 2015


Appendix D – Exam Proctor form

Challenge exam: Proctor form – Prior Learning Assessment

If you wish to write a challenge exam off-campus, please return this completed form to your Saskatchewan Polytechnic PLAR Assessor. Request this at Step 4 – Action Plan of the PLAR process.

Upon approval of the program head, the details and resources for the exam will be supplied to the exam proctor. You can write the exam under secure conditions when it is convenient to both of you.

Program Head

Medical Diagnostics Department programs

Saskatchewan Polytechnic, Saskatoon Campus

PO Box 1520

Saskatoon, SK S7K 3R5

The exam proctor/supervisor should be a professional

(teacher, RCMP, RN, secretary, clergy, etc.) and must be a non-relative.

Exam proctor/supervisor

Name: _________________________________________________________________

Occupation: _____________________________________________________________

Place of employment: _____________________________________________________

Address: _______________________________________________________________

Postal Code: ____________________________________________________________

Business phone: _________________________ Home phone: ___________________

Email address: ___________________________________________________________

Student’s name: (please print) _____________________________________________

List course(s) ___________________________________________________________

________________________________________________________________________ Signature: __________________________ Date_______________________________


Appendix E – Cover page

Evidence file for: ____________________________________________ (course code and name)

Name: ___________________________________________________

Address: _________________________________________________

Residence phone: __________________________________________

Business phone: ___________________________________________

City/town: ________________________________________________

Province, Postal Code: ______________________________________

Saskatchewan Polytechnic candidate #: ________________________

Email address: ____________________________________________

I attest that the enclosed evidence are correct and have been compiled by

myself. I attest that I am the person named in this application and the

evidence unless otherwise signified.

Signature: ____________________ Date: ___________________

phlebotomy applied certificate program...prior learning assessment and recognition phlebotomy...

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